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I don't know about others but gel is the not the end-all, be-all in antibody studies. For instance, if I am doing an warm auto - I have never been able to absorb all the warm ab out of the specimen if I test in gel. I always go with a PeG autoabsorption and do my studies in tubes rather than gel. I don't think I am going to miss any signficant allosensitization using tubes for this scenario. I still have referrals that use tubes and 22% albumin or LISS routinely, I like to be able to reproduce their results using the modalities that they use (when necessary). Sometmes gel is just way too sensitive and if I back off the sensitivity I can get a clear cut result. I feel the same way about the capture technology - sometimes it is way too sensitive. Tube testing, I believe, is still the standard of care regardless of what the vendors are saying or even that the majority of users use the newer technologies. I also do NOT run all specs in the cold - only if the studies indicate a likely cold reacting moiety.

I think you need to do some molecular biology. I guess you have a weak A subgroup. Most peculiar that it's coming up with the lectin and not the clones, but that could be something to do with the formulation of the reagents. There might be some potentiators in the lectin that aren't present in the clones, or the pH could be different etc etc. I agree with Malcolm that you need to test with human anti-A - tube technique. Use an excess of anti-A (if reagents aren't available, use group B plasma) and incubate at 4°C and (separately) at RT. That should give you some answers

My facility is in the final stages of implementing an OB Hemorrhage Protocol, which will be different than our Massive Transfusion Protocol. The California Maternal Quality Care Collaborative is an excellent resource for information on OB Hemorrhage. This is a link to their website https://www.cmqcc.org/ob_hemorrhage. Hope this helps!

I'm in Ireland and work in the National maternity hospital, we implemented a massive haemorrhage protocol in 2012. If you want any advice don't hesitate to send a PM Best wishes

According to Peter Issitt's book Applied Blood Group Serology (paraphased): Between 1 and 8% of A2 individuals produce Anti-A1, and approximately 22 and 35% of A2B individuals produce Anti-A1. So, it is very typical to not find Anti-A1 in the plasma of A2B patients. Donna

Only about 25% of A2B individuals will have an anti-A1 detected by routine ABO testing methods.