Transfusion-associated circulatory overload in a pediatric patient with neuroblastoma

There have been few reports on pediatric transfusion-associated circulatory overload (TACO). A 5-year-old boy with neuroblastoma underwent resection of the residual tumor. Because anemia progressed at the end of the operation, transfusion of red cell component was initiated. Ten minutes later, he suddenly developed hypoxemia, tachypnea, and tachycardia. Although elevated blood pressure and bilateral infiltrative shadows on chest X-rays were not observed, TACO was diagnosed based on positive balance during operation and N-terminal pro-brain natriuretic peptide elevation. He had no cardiac or renal disorder; however, mild cardiac and/or renal damage due to a long history of chemotherapy and bias toward his primary hematological and malignant disease may have affected the development of TACO.