TRANSFUSION-RELATED ACUTE LUNG INJURY CAUSED BY ANTI-HLA ANTIBODY IN A PATIENT WITH MYELODYSPLASTIC SYNDROME AND GASTRIC CANCER

Abstract

We report a case of transfusion-related acute lung injury (TRALI) most likely caused by anti-HLA antibody in a patient with myelodysplastic syndrome and gastric cancer. The patient was a 76-year-old Japanese male diagnosed with myelodysplastic syndrome and gastric cancer who required transfusion due to bleeding from the gastric cancer. Just after platelet transfusion, he felt dyspnea and chill, followed by an increase in body temperature to 39°C and a decrease in arterial oxygen saturation to 68%. Chest x-ray showed bilateral pulmonary edema, suggesting the development of TRALI. Platelet transfusion was stopped and oxygen therapy and steroid pulse therapy were started. The patient recovered in a few days. Anti-HLA class II antibodies were detected In the donor serum, and cross-match testing between donor serum and recipient lymphocytes was strongly positive. We assume that the cause of this case was an immune reaction through anti-HLA class II antibodies.