Serum levels of TNF- and IL-10 and prognostic risk factors in patients with transfusion-related acute lung injury

Objective: To investigate serum levels of Tumor necrosis factor alpha (TNF-alpha) and interleukin-10 (IL-10) in patients with transfusion-related acute lung injury (TRALI) and analyze the prognostic risk factors. Methods: 40 patients with TRALI, 42 patients with non-TRALI (acute lung injury caused by pulmonary infection or other reasons), and 40 healthy subjects were enrolled from our hospital. Results: TNF-alpha and IL-10 expressions in the healthy control group (HCG) and non-TRALI group was lower than that in the TRALI group, whereas the expressions in the non-TRALI group was higher than that in HCG (P < 0.05). In addition, the 48-hour survival rate in the TNF-alpha low-expression group (LEG) was higher than that in the high-expression group (HEG), whereas the 48-hour survival rate in the IL-10 LEG was lower than that in the HEG (P < 0.05). Further, TNF-alpha and IL-10 expressions are related to the amount of blood transfused, and IL-10 showed the best diagnostic efficacy with the biggest AUC while TNF-alpha showed the highest diagnostic sensitivity. Cox multiple-factor analysis results showed that the amount of blood transfusion was an independent prognostic risk factor for TRALI. Conclusions: TNF-alpha and IL-10 were risk factors of prognosis, but were not independent risk factors.