A Case of Transfusion-Related Acute Lung Injury after Total Arch Replacement for a Thoracic Aortic Aneurysm

(Department of Cardiovascular Surgery, and Divisions of Clinical Laboratory and Transfusion Medicine*, National Cerebral and Cardiovascular Center, Osaka, Japan)

Masatoshi Shimada Hiroshi Tanaka Hitoshi Matsuda
Hiroaki Sasaki Yutaka Iba Shigeki Miyata*
Hitoshi Ogino
An 84-year-old man with a thoracic aortic aneurysm underwent total arch replacement with selective antegrade cerebral perfusion. Immediately after the operation, respiratory distress and hypotension developed and Chest X-ray films and computed tomography showed bilateral lung edema. Echocardiography showed a small, underfilled left ventricle, but with preserved systolic function. We suspected transfusion-related acute lung injury(TRALI), and started sivelestat and steroid pulse therapy. His respiratory condition gradually improved, and he was discharged on postoperative day 78. The diagnosis of TRALI was confirmed by positive test results of an HLA class I antibody in the transfused fresh frozen plasma and T- and B-cells of the patient. TRALI should be considered as a cause of acute lung injury after surgery with blood transfusion.
  Jpn. J. Cardiovasc. Surg. 40:164-167(2011)

Keywords:cardiovascular surgery, blood transfusion, transfusion-related acute lung injury