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

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

Research output: Contribution to journalArticle


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 languageEnglish (US)
Pages (from-to)1294-1297
Number of pages4
JournalPaediatric anaesthesia
Issue number12
Publication statusPublished - Dec 1 2015
Externally publishedYes



  • 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

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