American Board of Internal Medicine (ABIM) Certification Practice Exam

When does Transfusion-Related Acute Lung Injury (TRALI) typically develop?

1. Within 24 hours of transfusion

2. Within 6 hours of transfusion

3. At the time of transfusion

4. Within 12 hours of transfusion

The correct answer is: Within 6 hours of transfusion

Transfusion-Related Acute Lung Injury (TRALI) is a serious complication that can occur following blood transfusions and is characterized by acute respiratory distress. It typically develops within six hours of the transfusion. This timeline is critical because TRALI is associated with the presence of neutrophils in the lung, activated by substances such as antibodies in the transfused blood products. The rapid onset of respiratory symptoms serves as an important clinical indicator for healthcare providers to consider TRALI as a potential diagnosis after a transfusion. While TRALI can technically occur at various times within the first 24 hours post-transfusion, identifying the peak incidence within the first six hours is essential for timely recognition and management. Understanding this timeframe helps clinicians monitor patients effectively and respond appropriately in case of symptoms suggestive of TRALI.