Transfusions are one of the most common procedures performed in the hospital setting, but the frequency of adverse events is often not recognized. These transfusion adverse events include transfusion associated circulatory overload (TACO), transfusion related acute lung injury (TRALI), febrile non hemolytic transfusion reactions (FNHTRs), allergic reactions, and transfusion related immunomodulation (TRIM). Red blood cell (RBC) and platelet transfusions are associated in a dose dependent fashion with high morbidity and mortality rates. Mounting evidence shows there is direct toxicity from these transfusions, mainly due to storage lesions, or effects of degradation of these products during storage. Some of the deleterious effects of transfusions appear to be mitigated by modifications such as washing. Pre transfusion washing of stored RBC and platelet units is an accepted and valuable blood product modification for patients with repeated and/or severe allergic reactions or FNHTRs [1]. Recent data from randomized controlled and observational clinical trials show that washing reduces inflammatory and immunologic complications including acute leukemia recurrence and elevations of inflammatory markers after pediatric cardiac surgery [2], [3]. That said, washing via the traditional NS found in most hospital systems may not be completely without side effects such as hemolysis of RBCs and decreased function in platelets. Using a physiological solution of Plasma Lyte A versus NS washing may mitigate the side effects of NS washing [1].