{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T05:10:52Z","timestamp":1791263452508,"version":"4.1.0"},"reference-count":24,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2014,12,15]],"date-time":"2014-12-15T00:00:00Z","timestamp":1418601600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Transfusion"],"published-print":{"date-parts":[[2015,5]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The etiology of transfusion\u2010related acute lung injury (<jats:styled-content style=\"fixed-case\">TRALI<\/jats:styled-content>) is often referred to as a \u201ctwo\u2010hit model,\u201d the first hit being patient predisposition and the second being a transfusion. This model lumps all patient\u2010related risk factors together and thereby may hamper identification of individual, potentially preventable or modifiable risk factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study design and methods<\/jats:title><jats:p>Like any disease, <jats:styled-content style=\"fixed-case\">TRALI<\/jats:styled-content> is multicausal in nature. To be able to effectively scrutinize all contributing causes, we need to clearly describe this multicausality as completely as possible. Several models are already commonly used to describe the multicausality of other diseases, including threshold models and the sufficient cause model.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Here we describe the application of two different multicausal models to <jats:styled-content style=\"fixed-case\">TRALI<\/jats:styled-content>. These models can readily describe any potential scenario for the etiology of <jats:styled-content style=\"fixed-case\">TRALI<\/jats:styled-content>. First we will introduce the intuitively appealing threshold model, which shows some similarities with the <jats:styled-content style=\"fixed-case\">B<\/jats:styled-content>ux and <jats:styled-content style=\"fixed-case\">S<\/jats:styled-content>achs threshold model for <jats:styled-content style=\"fixed-case\">TRALI<\/jats:styled-content>. Second we discuss the more abstract sufficient cause model.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Both models have their strengths and limitations. Both are, however, better equipped than the two\u2010hit model to describe the multicausal nature of <jats:styled-content style=\"fixed-case\">TRALI<\/jats:styled-content>. Further identification of all involved risk factors and the complex interplay between them is facilitated by these models.<\/jats:p><\/jats:sec>","DOI":"10.1111\/trf.12966","type":"journal-article","created":{"date-parts":[[2014,12,15]],"date-time":"2014-12-15T07:46:49Z","timestamp":1418629609000},"page":"953-960","source":"Crossref","is-referenced-by-count":26,"title":["Transfusion\u2010related acute lung injury not a two\u2010hit, but a multicausal model"],"prefix":"10.1111","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6545-7277","authenticated-orcid":false,"given":"Rutger A.","family":"Middelburg","sequence":"first","affiliation":[{"name":"Center for Clinical Transfusion Research Sanquin Research  Leiden The Netherlands"},{"name":"Jon J. van Rood Center for Clinical Transfusion Research Leiden University Medical Center  Leiden The Netherlands"},{"name":"Department of Clinical Epidemiology Leiden University Medical Center  Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johanna G.","family":"van der Bom","sequence":"additional","affiliation":[{"name":"Center for Clinical Transfusion Research Sanquin Research  Leiden The Netherlands"},{"name":"Jon J. van Rood Center for Clinical Transfusion Research Leiden University Medical Center  Leiden The Netherlands"},{"name":"Department of Clinical Epidemiology Leiden University Medical Center  Leiden The 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