Cognate antibody was demonstrated in 38 (16%) of the donors (see Fig.?1). Approximately half of the TRALI patients had an associated donor who was positive for HLA (cognate or noncognate) or HNA (46% adult, 53% pediatric). Thirteen percent of adults and 18% of pediatric patients had the cognate antigen that corresponded to donor HLA or had HNA. There was no significant difference between adult and pediatric patients in regard to their likelihood of having an associated donor with a cognate HLA or an HNA Enzalutamide order (p?=?0.6255). To obtain a crude TRALI incidence, the total number of RBC products used during the study period (2001-2011) was estimated. Extrapolation of the transfusion data from these data sets estimate that 4% of the national transfusions were provided to children less than 18 years old. Based on this assumption, the national incidence of reported TRALI cases was 5.58 per 100,000 RBC transfusions in pediatric patients. A similar calculation for adults provides an incidence of 3.75 per 100,000 Trametinib cost RBC transfusions. For both adults and children with TRALI, the incident rate fell over time. For children, the highest incidence was in 2005 at 11.29 per 100,000; by 2011 the incident rate fell to 3 per 100,000 (p?=?0.1740). For adults, the highest incident rate was in 2007 at 6.39 per 100,000; by 2011, the incident rate fell to 2.06 per 100,000 (p?=?0.0001). TRALI patient referral patterns differed between adult and pediatric patients. Most of the TRALI cases in pediatric patients (94%) were referred by tertiary care centers but only 47% of these were pediatric tertiary care centers. In contrast, 66% of all adult cases were referred by tertiary care centers. As well, most of the teenagers (8/11; 73%) were reported by ??adult?? hospitals, defined as hospitals that see primarily adult patients but house a pediatric department. All of the neonatal cases (<1 year old) were reported by tertiary care pediatric hospitals. TRALI is a rare but serious complication of blood transfusion in children and the literature in this population is sparse. This report highlights the similarities and differences between pediatric and adult patients presenting with TRALI. Only 17 pediatric cases of TRALI were PD-1 inhibitor reported to the CBS over an 11-year period. In this cohort, children and adults with TRALI were similar with respect to their clinical presentation, management, antibody profile of associated donors, and rates of mortality. Reported cases of TRALI declined over time in both adult and pediatric patients. In this study, approximately half of the definite, possible, or probable cases of TRALI were attributable to RBC components (8/17 pediatric cases, 47%; 140/267 adult cases, 52%). This finding is in contrast to some reports,[11, 12] but in keeping with others.