%0 Journal Article %A Akira Yokoyama %A Yukiyo Sakamoto %A Taisuke Jo %A Hirokazu Urushiyama %A Hiroyuki Tamiya %A Goh Tanaka %A Hiroki Matsui %A Kiyohide Fushimi %A Hideo Yasunaga %A Takahide Nagase %T Pulmonary disease as a risk factor for transfusion-related acute lung injury %D 2021 %R 10.1183/23120541.00039-2021 %J ERJ Open Research %P 00039-2021 %X Transfusion-related acute lung injury (TRALI) is a severe condition characterised by noncardiogenic pulmonary edema that develops within 6 h after blood transfusion. Patient factors and blood products have both been implicated in the development of TRALI; however, the role of pulmonary disease has not been investigated. We aimed to determine whether pulmonary disease is a risk factor for TRALI. We conducted a nested case-control study using data from the Diagnosis Procedure Combination database, a nationwide inpatient database in Japan, between July 2010 and March 2015. Case patients who developed TRALI were 1:4-matched with control patients for sex, age, and same hospital for receipt of blood transfusion. We conducted a multivariable conditional logistic regression analysis to evaluate the associations of TRALI with various factors including comorbidities, body mass index (BMI), and plasma-containing blood products. We identified 2,019,501 hospitalised patients who received a blood transfusion. Among these patients, 72 developed TRALI. The 72 case patients had higher proportions of hematological malignancy, trauma, and interstitial lung disease (ILD) than the 288 matched control patients. The multivariable conditional logistic regression analysis showed that occurrence of TRALI was associated with ILD (odds ratio, 3.88; 95% confidence interval, 1.11–13.6), BMI ≥25.0 kg·m−2 (2.10; 1.05–4.24), and plasma-containing blood products (1.94; 1.10–3.42), but not with infectious lung disease or obstructive airway disease. In conclusion, ILD was an independent risk factor for the development of TRALI. Physicians should be aware of the increased risk of TRALI in patients with ILD.FootnotesThis manuscript has recently been accepted for publication in the ERJ Open Research. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJOR online. Please open or download the PDF to view this article.Conflict of interest: Dr. Yokoyama has nothing to disclose.Conflict of interest: Dr. Sakamoto has nothing to disclose.Conflict of interest: Dr. Jo received the consigned research funding from Tsumura & Co., and belongs to a laboratory, which is a joint program with Tsumura & Co.Conflict of interest: Dr. Urushiyama has nothing to disclose.Conflict of interest: Dr. Tamiya has nothing to disclose.Conflict of interest: Dr. Tanaka has nothing to disclose.Conflict of interest: Dr. Matsui has nothing to disclose.Conflict of interest: Dr. Fushimi has nothing to disclose.Conflict of interest: Dr. Yasunaga reports grants from Ministry of Health, Labour, and Welfare, Japan, during the conduct of the study.Conflict of interest: Dr. Nagase has nothing to disclose. %U https://openres.ersjournals.com/content/erjor/early/2021/06/25/23120541.00039-2021.full.pdf