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

Abstract

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.

• Authors: Natalie K Smith, Sang Kim, Bryan Hill, Andrew Goldberg, Samuel DeMaria, Jeron Zerillo
• Journal: Seminars in cardiothoracic and vascular anesthesia (Semin Cardiothorac Vasc Anesth) Vol. 22 Issue 2 Pg. 180-190 (Jun 2018) ISSN: 1940-5596 [Electronic] United States
• PMID: 29025378 (Publication Type: Case Reports, Journal Article, Review)

Topics

• Aged
• Humans
• Liver Transplantation (adverse effects)
• Male
• Transfusion Reaction (etiology)
• Transfusion-Related Acute Lung Injury (etiology, prevention & control, therapy)