Transfusion-Related Acute Lung Injury (TRALI) and Transfusion-Associated Circulatory Overload (TACO) in Liver Transplantation: A Case Report and Focused Review. 2018

Natalie K Smith, and Sang Kim, and Bryan Hill, and Andrew Goldberg, and Samuel DeMaria, and Jeron Zerillo
1 The Icahn School of Medicine at Mount Sinai Hospital, New York, NY, USA.

Liver transplantation (LT) is a complex procedure in a patient with multi-organ system dysfunction and coagulation defects. The surgical procedure involves dissection, major vessel manipulation, and pathophysiologic effects of graft storage and reperfusion. As a result, LT frequently involves significant hemorrhage. Subsequent massive transfusion carries high risk of transfusion-associated complications. Transfusion-related acute lung injury (TRALI) and transfusion-associated circulatory overload (TACO) are the leading causes of transfusion associated mortality. In this case report and focused review, we present data that suggest that patients undergoing liver transplantation may be at higher risk for TRALI and TACO than the general population. Anesthesiologists can play a role in decreasing these risks by increasing recognition and reporting of TRALI and TACO, using point of care testing with thromboelastography to guide and decrease transfusion, and considering alternatives to traditional blood products like solvent/detergent plasma.

UI MeSH Term Description Entries
D008297 Male Males
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000073617 Transfusion-Related Acute Lung Injury A rare but serious transfusion-related reaction in which fluid builds up in the lungs unrelated to excessively high infusion rate and/or volume (TRANSFUSION-ASSOCIATED CIRCULATORY OVERLOAD). Signs of Transfusion-Related Acute Lung Injury include pulmonary secretions; hypotension; fever; DYSPNEA; TACHYPNEA; TACHYCARDIA; and CYANOSIS. Acute Lung Injury, Transfusion-Related,TRALI,Acute Lung Injury, Transfusion Related,Transfusion Related Acute Lung Injury
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D016031 Liver Transplantation The transference of a part of or an entire liver from one human or animal to another. Grafting, Liver,Hepatic Transplantation,Liver Transplant,Transplantation, Hepatic,Transplantation, Liver,Hepatic Transplantations,Liver Grafting,Liver Transplantations,Liver Transplants,Transplant, Liver
D065227 Transfusion Reaction Complications of BLOOD TRANSFUSION. Included adverse reactions are common allergic and febrile reactions; hemolytic (delayed and acute) reactions; and other non-hemolytic adverse reactions such as infections and adverse immune reactions related to immunocompatibility. Delayed Hemolytic Transfusion Reaction,Acute Hemolytic Transfusion Reaction,Blood Transfusion-Associated Adverse Reactions,Delayed Serologic Transfusion Reaction,Febrile Non-Hemolytic Transfusion Reaction,Hemolytic Transfusion Reaction,Hypotensive Transfusion Reaction,Post-Transfusion Purpura,Posttransfusion Purpura,TAGHD,Transfusion-Associated Allergic Reaction,Transfusion-Associated Circulatory Overload,Transfusion-Associated Dyspnea,Transfusion-Associated Graft Vs. Host Disease,Transfusion-Transmitted Infection,Allergic Reaction, Transfusion-Associated,Blood Transfusion Associated Adverse Reactions,Circulatory Overload, Transfusion-Associated,Circulatory Overloads, Transfusion-Associated,Dyspnea, Transfusion-Associated,Febrile Non Hemolytic Transfusion Reaction,Hemolytic Transfusion Reactions,Infection, Transfusion-Transmitted,Post Transfusion Purpura,Posttransfusion Purpuras,Purpura, Post-Transfusion,Purpura, Posttransfusion,Reaction, Hemolytic Transfusion,Reaction, Hypotensive Transfusion,Reactions, Hemolytic Transfusion,Transfusion Associated Allergic Reaction,Transfusion Associated Circulatory Overload,Transfusion Associated Dyspnea,Transfusion Associated Graft Vs. Host Disease,Transfusion Reaction, Hemolytic,Transfusion Reaction, Hypotensive,Transfusion Reactions,Transfusion Reactions, Hemolytic,Transfusion Reactions, Hypotensive,Transfusion Transmitted Infection,Transfusion-Associated Circulatory Overloads,Transfusion-Transmitted Infections

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