title: [Transfusion-related acute lung injury caused by anti-leukocyte antibodies found in patient's serum and donor plasma].
abstract: We report a case of transfusion-related acute lung injury (TRALI) with anti-leukocyte antibodies detected both in the patient's serum and in the causative fresh frozen plasma. The patient was a 72-year-old Japanese woman who had undergone colectomy and stoma closure under general anesthesia. Intraoperatively she received 8 units of red cell concentrate and 12 units of fresh frozen plasma. At the end of surgery she was fully awake and extubated. Shortly after extubation her oxygen saturation dropped (90%) and she developed dyspnea. A chest X-ray revealed bilateral diffuse pulmonary edema without cardiac enlargement. The patient was re-intubated and placed on respiratory support with positive end-expiratory pressure ventilation. Her pulmonary edema improved and she was extubated again at 20 hours after surgery. Antibodies to human leukocyte antigen were detected in serum from the patient and in serum samples of the freshly frozen donor plasma; a crossmatch test of the patient's lymphocytes and donor serum was positive. We believe that anti-leukocyte antibodies caused TRALI via an immune-mediated mechanism.
authors: Department of Anesthesiology, Kumamoto Chuo Hospital, Kumamoto 862-0965.
authors: Kengo
authors: K
authors: Maekawa
authors: Naofumi
authors: N
authors: Isobe
authors: Takahiro
authors: T
authors: Nonaka
authors: Masafumi
authors: M
authors: Fujimoto
authors: Sumi
authors: S
authors: Otomo
authors: Tomoko
authors: T
authors: Baba
authors: Yasuko
authors: Y
authors: Maeda
mesh_terms: D055371:Acute Lung Injury / Q000276:immunology*; D000368:Aged; D001782:Blood Donors; D005260:Female; D006801:Humans; D007518:Isoantibodies / Q000097:blood*; D007962:Leukocytes / Q000276:immunology*; D065227:Transfusion Reaction
chemical_list: D007518:Isoantibodies