Complications due to transfusion-related acute lung injury.

Abstract

Transfusion-related acute lung injury is an underdiagnosed and potentially lethal complication of blood transfusion. A patient underwent surgery because of an ectopic pregnancy. During surgery, blood products were administered and within minutes she developed pulmonary edema and hypotension. Treatment included mechanical ventilation, intravenous fluids, antihistamines, inotropic agents, cortisol, and diuretics. It took 4 days for the pulmonary edema to resolve and the patient to recover. Analysis of the donor plasma revealed human leukocyte antigen antibodies against an antigen of the patient. Although transfusion-related acute lung injury is usually self-limiting and most patients will recover spontaneously, the estimated mortality rate of 5-25% warrants prompt identification and adequate action.