Blood Transfusion in Surgery

A 52-year-old man with peptic ulcer disease presents to the emergency department with haematemesis and melaena. On examination, he is pale, diaphoretic, with blood pressure 88/54 mmHg, heart rate 118/min, and respiratory rate 24/min. His haemoglobin is 6.2 g/dL, and he has received 2 litres of normal saline intravenously without haemodynamic improvement. The patient is Rh-negative with an anti-D antibody titre of 1:16 (previously sensitised). What is the most appropriate blood product to transfuse at this moment?

A 68-year-old woman with severe aortic stenosis undergoes elective aortic valve replacement. Intraoperatively, after 4 hours of cardiopulmonary bypass, she receives 6 units of packed red blood cells, 4 units of fresh frozen plasma, and 1 unit of platelet concentrate. Post-operatively, she develops oozing from the surgical site, petechiae on the lower limbs, and haematuria. Laboratory investigations show: PT 18 seconds (INR 1.8), aPTT 52 seconds, platelet count 45,000/μL, fibrinogen 0.8 g/dL (normal 2–4 g/dL). What is the most likely diagnosis and the next immediate step in management?

Which blood component is most appropriate for correcting coagulopathy in a patient with massive transfusion (>10 units of PRBC in <24 hours)?

What is the maximum safe storage duration for Fresh Frozen Plasma (FFP) at −18°C or colder?