[Acute lung injury related to transfusion of fresh frozen plasma].
A 23-year-old woman with no relevant medical history required transfusion of 2 units of fresh frozen plasma before diagnostic laparoscopy. Following transfusion, serious bilateral pulmonary edema with hypoxia developed and resolved with 48 hours of mechanical ventilation. Immunological testing of blood from the 2 donors and the patient revealed the presence of anti-HLA DR-52 antibodies in the plasma of a donor and the presence of the corresponding antigen in the patient, confirming the diagnosis of fresh frozen plasma transfusion-related acute lung injury. Transfusion-related acute lung injury associated with plasma-containing blood products has an incidence of 1:5000 transfused units and a mortality rate of up to 10% of cases. Clinical suspicion should remain high in making the diagnosis and ruling out other causes of pulmonary edema, given that a firm diagnosis will come only after immunological testing. Transfusion-related acute lung injury is considered an under-diagnosed syndrome and must be included in the differential diagnosis of respiratory distress when a transfusion has been given.
Servicio de Anestesiología y Reanimación, Hospital Arnau de Vilanova, Valencia. jabama16@hotmail.com
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Barrio
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Carrera
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Sanmiguel
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García
D000328:Adult; D005260:Female; D006801:Humans; D010949:Plasma; D012128:Respiratory Distress Syndrome / Q000209:etiology*; D065227:Transfusion Reaction