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Anesth Analg 2005;101:499-501
© 2005 International Anesthesia Research Society
doi: 10.1213/01.ANE.0000159375.26910.9C

CRITICAL CARE AND TRAUMA

Severe Transfusion-Related Acute Lung Injury

Lukas Brander, MD*, Angelika Reil, MD{ddagger}, Juergen Bux, MD, PhD{ddagger}, Behrouz Mansouri Taleghani, MD{dagger}, Bruno Regli, MD*, and Jukka Takala, MD, PhD*

*Department of Intensive Care Medicine and {dagger}Department of Hematology and Central Hematology Laboratory, Division of Transfusion Medicine, University Hospital-Inselspital, Bern, Switzerland; and {ddagger}Blood Transfusion Service, SRC Bern Ltd., Bern, Switzerland

Address correspondence to Lukas Brander, MD, Department of Intensive Care Medicine, University Hospital, Inselspital, 3010 Bern, Switzerland. Address e-mail to lukas.brander{at}insel.ch.

A 46-yr-old man developed severe hypoxemia, pulmonary infiltrates, and an acute decrease in his leukocyte count shortly after transfusion of fresh-frozen plasma (FFP) during recovery from cardiac surgery. Cardiogenic pulmonary edema was excluded. Granulocyte-reactive and agglutinating alloantibodies were detected in the serum of the fresh-frozen plasma donor. The cross-match with the patient’s granulocytes revealed antibodies specific for HLA class I. Transfusion-related acute lung injury (TRALI) is a potentially life-threatening, under-recognized and under-reported complication of transfusion. Conservative transfusion strategies and preclusion of the implicated blood donors with granulocyte-reactive antibodies from future blood donation may prevent TRALI and could save lives.




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Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2005 by the International Anesthesia Research Society.