Transfusion

Explanations:
Hypocalcaemia can occur in excessive transfusion of blood with acid citrate dextrose.

After transfusion of stored blood citrate metabolized in body and Produce HCO3- leads to metabolic alkalosis (Citrate is anticoagulant in blood bag).

Explanations:
Agglutinogens are present on RBC membrane & agglutinins are present on serum.

Acute Kidney Failure After Transfusion Reactions

One of the most lethal effects of transfusion reactions is kidney failure, which can begin within a few minutes to a few hours and continue until the person dies of acute renal failure.

The kidney shutdown seems to have three causes:

1. The antigen-antibody reaction of the transfusion reaction releases toxic substances from the hemolyzing blood that cause powerful renal vasoconstriction

2. Loss of circulating RBCs in the recipient, along with production of toxic substances from the hemolyzed cells and the immune reaction, often. cause circulatory shock. The arterial blood pressure falls very low, and renal blood flow and urine output decrease.

3. If the total amount of free hemoglobin released into the circulating blood is greater than the quantity that can bind with haptoglobin (a plasma protein that binds small amounts of hemoglobin), much of the excess leaks through the glomerular membranes into the kidney tubules.

Hazards in mismatched blood transfusion / ABO/Rh incompatibility
 
A. Immediate effects:
1. Acute hemolytic reaction 
2. Shivering and restlessness
3. Nausea and vomiting 
4. Chest pain and back pain
5. Heart/respiratory rate- increased
6. Blood pressure- decreased
7. Shock

Explanations:
Agglutinogens are present on RBC membrane & agglutinins are present on serum.

Composition
FFP contains labile as well as stable components of the coagulation, fibrinolytic and complement systems, the protiens that maintain oncotic pressure and modulate immunity.
In addition fats, carbohydrates and minerals are present in concentrations similar to circulation.
The analysis of 35 samples of FFP show mean concentrations of of 535mg/dl Glucose, 172mEq/L. Na+, 73mEq/L Cl-, Cl-, 3.5mEq/Lk 3.5mEq/L. K+, 15mEq/L HCO3-and  protien with 60% albumin. 5-5g/dl
Thus FFP is a hyperosmolal, hyperglycemic, hypernatremic and hypochloremic solution.
It is a less effective volume expander than other albumin containing solutions, due to its lower albumin content.

Indications
Multiple coagulation factor deficiencies e.g.
DIC
Massive blood transfusion
Liver disease
Active or ongoing bleeding with abnormal coagulation tests
"Thrombotic thrombocytopaenic purpura
Vitamin K deficiency associated with active bleeding

Explanations: ‘O’ group has no antigen & AB group has no antibody.