Transfusion associated circulatory overload (TACO) is an established, but grossly under diagnosed and underreported complication of blood transfusion. We present the case of a 46-year-old diabetic and hypertensive patient admitted to our hospital for recurrent episodes of urinary retention. Over initial 3 days of the admission, the patient received multiple units of packed red blood cells (RBC) and fresh frozen plasma, uneventfully. However, the patient developed signs and symptoms suggestive of TACO with only small amount of the 4 th unit of RBC. The patient had to be shifted to the Intensive Care Unit for further management of this complication. Etiology of TACO is more complex than a mere circulatory overload and is still not completely understood. TACO leads to a prolonged hospital stay and morbidity in the patients developing this complication. TACO thus needs to be suspected in patients at risk for this complication.
Blumberg N, Heal JM, Gettings KF, Phipps RP, Masel D, Refaai MA, et al. An association between decreased cardiopulmonary complications transfusion-related acute lung injury and transfusion-associated circulatory overload and implementation of universal leukoreduction of blood transfusions. Transfusion 2010;50:2738-44.
Li G, Kojicic M, Reriani MK, Fernández Pérez ER, Thakur L, Kashyap R, et al. Long-term survival and quality of life after transfusion-associated pulmonary edema in critically ill medical patients. Chest 2010;137:783-9.
Bolton-Maggs PH, Cohen H On Behalf of the Serious Hazards of Transfusion (SHOT) Steering Group. The 2011 Annual SHOT Report, 2012. Available from: http://www.shotuk.org/wp-content/uploads/2012/07/shot-annual-report_FinalWebVersionBookmarked_2012_06_22.pdf. [Last accessed on 2013 May 01]
Alam A, Lin Y, Lima A, Hansen M, Callum JL. The prevention of transfusion-associated circulatory overload. Transfus Med Rev 2013;27:105-12.
Popovsky MA, Robillard P, Schipperus M, Stainsby D, Tissot JD, Wiersum J. ISBT Working Party on Hemovigilance. Proposed standard definitions for surveillance of noninfectious adverse transfusion reactions, 2006. Available from: http://www.ihn-org.com/wp-content/uploads/2011/06/ISBT-definitions-for-non-infectious-transfusion-reactions.pdf. [Last accessed on 2013 May 01].