The priming step of transfusion-related ALI—TRALI may be associated with NLRP3 inflammasome expression in various types of lung immune and endothelial cells, which constitute what is known as the “first hit”, while DAMPs from stored blood units with some degree of hemolysis, leading to the presence of heme or extracellular ATP may induce inflammasome activation and subsequent inflammation, resulting in a “second hit” [94]. Here, NLRP3 is linked to acute respiratory distress syndrome.