Background
Transfusion-related acute lung injury (TRALI) is characterized clinically by the onset of acute respiratory distress syndrome (ARDS) within 6 hours of initiation of blood transfusion with difficulty breathing, hypoxemia, hypotension, and bilateral pulmonary edema [1]. TRALI is a major cause of blood transfusion-related death. The differential diagnosis of TRALI includes heart failure and pneumonia. TRALI occurs in the peri-operative period in 1.3-1.4% of patients who receive a blood transfusion [2]. Though approximately 80% of patients recover from TRALI within 2 to 3 days, the reported mortality rate is 13-18% [3,4]. The case of a patient who developed TRALI after intra-operative platelet transfusion in whom veno-venous extracorporeal membrane oxygenation (VV-ECMO) support for severe and refractory hypoxemia was effective for life-saving is presented. The patient’s written, informed consent for publication of this case report was obtained.