手術後與輸血有關的肺水腫之病例報告

Postoperative Pulmonary Edema, Transfusion-related?-- A Case Report

與輸血有關的急性肺損傷，是在輸含有血漿的血液的時候，白血球抗原與抗體發生嚴重的反應所造成。近年來，產生於非血漿的血液製品且具有生物活動力的脂肪也被認為是造成輸血有關的急性肺損傷得另一個原因。它雖然罕見，卻是個預後不錯的疾病。我們報告了一例發生手術後肺水腫的病案，觀察疾病發生的時間與其臨床的表現，它與輸血有關的急性肺損傷相當吻合。疾病發生的時候，我們沒有立即懷疑輸血有關的急性肺損傷，使得事後實驗室的確定診斷變成非常困難。即便如此，在接受了支持性治療的三十六小時後，病人完全的康復了。沒有尋獲造成問題的捐血者，類似的輸血反應或急性肺損傷將無法避免。

Transfusion-related acute lung injury (TRALI) is a severe reaction between leukocyte antigen and antibody during transfusion of plasma-containing components. Recently, biologically active lipids have been also suggested to cause the disorder. It is a rare, but rather benign pulmonary edema. We report a postoperative pulmonary edema, which was temporally and clinically compatible with TRALI. Because the patient received blood products from 3 or 4 donors and the disorder was not recognized right away, the laboratory task for the definite diagnosis was difficult. Nevertheless, the patient had fully recovered in 36 hours after supportive therapies. Without identifying the blood donor implicated in the disorder, transfusion reactions or TRALI will be inevitable.