The exact cause of TRALI is not fully understood, but it is believed to involve an immune reaction between the recipient's leukocytes and donor antibodies. This reaction leads to the activation of the recipient's neutrophils and endothelial cells, causing capillary leakage and pulmonary edema. Factors such as the immaturity of the neonatal immune system and the presence of underlying conditions like sepsis or prematurity may increase the risk of TRALI.
