Volume 25, Issue 12 pp. 1294-1297
Case Report

Case report of transfusion-related acute lung injury in a pediatric spine surgery patient transfused leukoreduced red blood cells

Elizabeth M. Cudilo

Elizabeth M. Cudilo

Department of Anesthesiology, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA

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Anna M. Varughese

Anna M. Varughese

Department of Anesthesiology and Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA

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Mohamed Mahmoud

Mohamed Mahmoud

Department of Anesthesiology and Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA

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Patricia M. Carey

Patricia M. Carey

Transfusion Service, Department of Clinical Pathology and Laboratory Medicine, University of Cincinnati, Cincinnati, OH, USA

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Rajeev Subramanyam

Corresponding Author

Rajeev Subramanyam

Department of Anesthesiology and Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA

Correspondence

Rajeev Subramanyam, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, MLC 2001, Cincinnati, OH 45229, USA

Email: [email protected]

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First published: 30 June 2015
Citations: 3

Summary

Despite leukoreduced red blood cells (LR-RBCs) reducing the risk of transfusion-related acute lung injury (TRALI), we present a case of a 16-year-old female with kyphosis who received a transfusion of one unit of LR-RBCs, which lead to life-threatening, intraoperative TRALI. The clinical presentation included pulmonary edema, severe postoperative lactic acidosis, left ventricular dysfunction, increased creatine phosphokinase, fatty infiltration of the liver, and hemodynamic instability requiring inotropic support. This presentation is not the classic description of TRALI. Our patient improved with supportive treatment and was successfully extubated on postoperative day 4. TRALI work-up revealed antibody formation to HLA A2, A68, B44, and DQA 5 for the LR-RBCs unit administered.

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