Transfusion-related acute lung injury.

A 49 year-old man with a history of alcohol-induced cirrhosis presented for orthotopic liver transplantation. His medical history is remarkable for mild hypertension treated with metoprolol and aldactone; recent admissions for ascitic fluid drainage, spontaneous bacterial peritonitis and transient episodes of hepatic encephalopathy; and a prior history of an open cholecystectomy. His admission laboratories were remarkable for serum sodium of 132 mEq/L, BUN of 25 mEq/dL, creatinine of 1.9 mg/dL, hemoglobin of 9.8 mg/dL, INR of 2.0 sec, platelet count of 85,000, albumin of 2.0 mg/dL, bilirubin of 4.1 mg/dL, and a normal CXR and ECG. His MELD score was 26. Physical examination revealed a 75 Kg male with obvious ascites, some stigmata of chronic liver disease and decreased breath sounds, but otherwise an unremarkable exam. BP was 118/70 and heart rate of 70 BPM.