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Transfusing A2 patients


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#1 kimblain

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Posted 31 January 2013 - 02:50 PM

What are your practices transfusing A2 patients. Do you automatically transfuse O type blood or do you wait until that patient presents with an Anti-A1?



#2 PAWHITTECAR

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Posted 31 January 2013 - 03:19 PM

My first thought is why do you know they are A2. I have never worked anywhere that A1 lectin testing was routinely performed. We do A1 lectin on potential organ recipients and would automatically give them O cells. The only other people that we do A1 lectin on have a type discrepiency due to Anti-A1 and we then give them O cells.

#3 John C. Staley

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Posted 31 January 2013 - 03:20 PM

I don't remember ever knowing a patient was an A2 until after they produced an anti-A1! Sounds like it would be a lot of bother and expense for little benefit. :faint:
John C. Staley CLS/MT

#4 kimblain

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Posted 31 January 2013 - 03:54 PM

We do not routinely us Anti-A1 lectin in our service either. It was requested for possible donors. Once we do the typing and find out they are not A1 I will put transfuse with O type blood. I wanted to know if this was common practice

#5 PAWHITTECAR

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Posted 31 January 2013 - 04:15 PM

Thanks for the clarification.

#6 Malcolm Needs

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Posted 31 January 2013 - 07:39 PM

1. Apart from renal transplants, I can't see the point of typing with anti-A1 (human, monoclonal or lectin).

2. Unless the anti-A1 reacts strictly at 37oc, why on Earth give group O blood, instead of cross-match compatible group A blood? How many of you have come across an anti-A1 that has caused a haemolytic transfusion reaction? How many of you have read about one that has caused a haemolytic transfusion reaction (apart from the recent publication in, I think Transfusion, but I could be wrong there, that involved a very rare and extreme case in a BMT recipient)?

NOT ALL ANTIBODIES ARE CLINICALLY SIGNIFICANT.

:explosion:explosion:explosion:explosion:explosion:disbelief:disbelief:disbelief:disbelief:disbelief

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#7 PAWHITTECAR

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Posted 31 January 2013 - 08:38 PM

I totally agree Malcolm. We only gave O to the kidney transplant patients that were A2

#8 kimblain

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Posted 31 January 2013 - 08:49 PM

Thank you for your feedback

#9 Mabel Adams

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Posted 01 February 2013 - 01:30 AM

We give O blood to our patients with anti-A1 because it keeps our computer happy. It happens maybe once a year, if that.

#10 shily

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Posted 01 February 2013 - 04:29 AM

1. Apart from renal transplants, I can't see the point of typing with anti-A1 (human, monoclonal or lectin).

:explosion:explosion:explosion:explosion:explosion:disbelief:disbelief:disbelief:disbelief:disbelief


Thanks Malcolm for your post.
If you have time, please explain why renal transplants need to be tested for A1 or Asub on detail. Thank you.
Yanxia Wang

#11 Malcolm Needs

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Posted 01 February 2013 - 11:39 AM

HI Yanxia.

Actually, it isn't the renal transplant patients that we test with A1, but we test the donors for A1 if the donor kidney is going to be transplanted into a group O or group B patient. In other words, in the case of a potential ABO incompatible renal transplant, the renal surgeons like to know whether the donor is an A1, A2, A subgroup. This is because they have to get the anti-A titre of the recipient down to as low a level as possible (to prevent graft rejection), and, in such circumstances, A2 renal transplants tend to be more successful than A1 renal transplants (because the A antigen on the red cells and the kidneys of an A1 donor is expressed more strongly than the A antigen on the red cells and the kidneys of an A2 donor).

Malcolm Needs :wave:


#12 msdesoki

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Posted 01 February 2013 - 01:22 PM

What are your practices transfusing A2 patients. Do you automatically transfuse O type blood or do you wait until that patient presents with an Anti-A1?


the only problem is presnce of ati A1 (however there is severe doubt about its significant), so I think if these is no anti-A1 no problem to issue A group, but if there is anti-A1 best to issue same subgroup or O.

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What are your practices transfusing A2 patients. Do you automatically transfuse O type blood or do you wait until that patient presents with an Anti-A1?


the only problem is presnce of ati A1 (however there is severe doubt about its significant), so I think if these is no anti-A1 no problem to issue A group, but if there is anti-A1 best to issue same subgroup or O.

#13 cthherbal

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Posted 01 February 2013 - 01:46 PM

We give O blood to our patients with anti-A1 because it keeps our computer happy. It happens maybe once a year, if that.


We do the same as Mabel. All generalists here in BB and then confusion ensues (do we give A1 neg units, etc.) So for the rare instance this occurs, we give Group O RBCs.

#14 silverblood

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Posted 01 February 2013 - 03:48 PM

Our policy is to give O blood to patients who type as A2-this has been the recommendation of our reference lab also.

#15 cswickard

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Posted 01 February 2013 - 04:01 PM

Nothing wrong with using some A1 lectin to screen for A2 units either, I would think. Or AHG crossmatch compatible A units too. And it is more comfortable to do and see the XM phase (usually I.S.) where the anti A1 is seen too as part of the crossmatch. (Supposed to do that anyhow now according to the standards for detection of ABO compatiblity.)

If the A unit is compatible at I.S. and whatever coombs phase test you use, should be OK to give. We have done this on our rare anti-A1 patients without problems.

#16 tbostock

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Posted 01 February 2013 - 08:36 PM

We also give type O for A2 patients making an anti-A1. To make the computer happy, like Mabel said, and also because the techs feel more comfortable. It happens so rarely, not a big deal to give an occasional type O to someone who really doesn't need it.
Terri Bostock, MT(ASCP)

#17 adiescast

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Posted 05 February 2013 - 05:26 PM

We often give type O to patients with anti-A1 mostly because it is quick and easy (and doesn't confuse the poor computer).

#18 Likewine99

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Posted 06 February 2013 - 01:56 AM

We give O cells like everyone else. Keeping the BB system and especially the techs happy is always a good idea in my book:D

#19 sshel55

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Posted 06 February 2013 - 04:25 PM

Crossmatch compatible group A RBC would be transfused in our facility.

#20 Kathy

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Posted 30 March 2013 - 08:59 PM

On this same line of thought, I assume that you would also give type A1 blood in the following scenario: Twins <1 month old at our hospital. One is type A (positive with A1 lectin), and the other is possible type A3 (mixed field reactions with anti-A, has not been transfused, negative with A1 lectin). Neither has anti-A1 in their serum at immediate spin or IgG. We have a directed donor type A1 unit from one of the parents. Unit is fully compatible with the A subgroup twin. Do we give the directed donor unit to the A subgroup twin? If so, should we get specimens every 3 days to ensure that the baby doesn't start making anti-A1? I know that babies don't normally make anti-A until 3-6 months, but I'm not sure I want to take any chances.



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