Transfusing blood after prolonged storage could lead to –
**Core Concept**
Prolonged storage of blood can lead to changes in its composition and function, affecting its compatibility and efficacy when transfused into the recipient. This is due to the breakdown of cellular components and the accumulation of byproducts, such as potassium ions and free hemoglobin.
**Why the Correct Answer is Right**
The correct answer is related to the accumulation of potassium ions in stored blood. During storage, red blood cells (RBCs) undergo hemolysis, releasing potassium ions into the plasma. Elevated potassium levels in the transfused blood can lead to hyperkalemia in the recipient, potentially causing cardiac arrhythmias, muscle weakness, and even cardiac arrest. This is a critical concern, especially in patients with pre-existing kidney disease or those receiving multiple blood transfusions.
**Why Each Wrong Option is Incorrect**
**Option A:** This is not directly related to the effects of prolonged blood storage. While citrate preservative can cause metabolic alkalosis, it is not the primary concern with prolonged storage.
**Option B:** This option is incorrect as the primary concern with prolonged blood storage is not the accumulation of free hemoglobin, but rather the breakdown of RBCs and the release of potassium ions.
**Option C:** This option is not directly related to the effects of prolonged blood storage. While blood transfusion reactions can occur due to ABO incompatibility, it is not a direct consequence of prolonged storage.
**Clinical Pearl / High-Yield Fact**
When transfusing blood, it is essential to consider the storage duration and the recipient's underlying medical conditions. The AABB recommends that blood be transfused within 21-35 days of storage, and the recipient's potassium levels should be monitored closely.
**Correct Answer: B. Hyperkalemia.**