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

Elizabeth M. Cudilo; Anna M. Varughese; Mohamed Mahmoud; Patricia M. Carey; Rajeev Subramanyam

doi:10.1111/pan.12696

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

Elizabeth M. Cudilo, Anna M. Varughese, Mohamed Mahmoud, Patricia M. Carey, Rajeev Subramanyam

Research output: Contribution to journal › Article › peer-review

2 Scopus citations

Abstract

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.

Original language	English (US)
Pages (from-to)	1294-1297
Number of pages	4
Journal	Paediatric anaesthesia
Volume	25
Issue number	12
DOIs	https://doi.org/10.1111/pan.12696
State	Published - Dec 2015
Externally published	Yes

Keywords

adolescent
blood transfusion
donor antibody
scoliosis/kyphosis
spinal fusion
transfusion-related acute lung injury

ASJC Scopus subject areas

Pediatrics, Perinatology, and Child Health
Anesthesiology and Pain Medicine

Access to Document

10.1111/pan.12696

Cite this

@article{8b4916aa3c7249ea91ebaf44d0c97ca6,

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

abstract = "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.",

keywords = "adolescent, blood transfusion, donor antibody, scoliosis/kyphosis, spinal fusion, transfusion-related acute lung injury",

author = "Cudilo, {Elizabeth M.} and Varughese, {Anna M.} and Mohamed Mahmoud and Carey, {Patricia M.} and Rajeev Subramanyam",

note = "Publisher Copyright: {\textcopyright} 2015 John Wiley & Sons Ltd.",

year = "2015",

month = dec,

doi = "10.1111/pan.12696",

language = "English (US)",

volume = "25",

pages = "1294--1297",

journal = "Paediatric anaesthesia",

issn = "1155-5645",

publisher = "John Wiley and Sons Inc.",

number = "12",

}

TY - JOUR

T1 - Case report of transfusion-related acute lung injury in a pediatric spine surgery patient transfused leukoreduced red blood cells

AU - Cudilo, Elizabeth M.

AU - Varughese, Anna M.

AU - Mahmoud, Mohamed

AU - Carey, Patricia M.

AU - Subramanyam, Rajeev

PY - 2015/12

Y1 - 2015/12

N2 - 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.

AB - 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.

KW - adolescent

KW - blood transfusion

KW - donor antibody

KW - scoliosis/kyphosis

KW - spinal fusion

KW - transfusion-related acute lung injury

UR - http://www.scopus.com/inward/record.url?scp=84946478148&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84946478148&partnerID=8YFLogxK

U2 - 10.1111/pan.12696

DO - 10.1111/pan.12696

M3 - Article

C2 - 26126598

AN - SCOPUS:84946478148

SN - 1155-5645

VL - 25

SP - 1294

EP - 1297

JO - Paediatric anaesthesia

JF - Paediatric anaesthesia

IS - 12

ER -

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

Abstract

Keywords

ASJC Scopus subject areas

Access to Document

Other files and links

Fingerprint

Cite this