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ackkap - Thanks so much for the follow up! I'm so glad to hear the baby is safe. I haven't seen a case like yours in years so it would be very worthwhile to write it up as a case study. ARC's Immunohematology journal would be a good spot to place it. They still publish practical topics for us serologists. Even better, following this woman could be really interesting. Any chance she might get pregnant again? Technically she isn't a candidate for RhIg but in practical terms - might it prevent her converting to IgG? A shot won't hurt her or the baby. Afterall we give it to D+ ITP patients to help boost their platelet count using the competitive binding theory. You will have to keep an eye out to see if this delivery prompts her to convert to IgG. I've never seen one of these past a single pregnancy. Best of Luck!!

Or answering the phone by holding the bar code scanner to your ear !

I think Parafilm should be available for home use.

My guess is that this is due to anti-A. I think the 'weak D' thing is probably just due to the weak pos DAT. You should check the D type with monoclonal anti-D reagents. and if the baby is Ok I would not worry about a 1+ DAT Anna

Our policy is to repeat screen by gel and do a panel before determining if we are calling screen Neg or Pos. We are strict with this because antibodies have been missed in the past. We had one sample yesterday weak on SC2, tech thought it was visually negative but on ficin panel was a clear anti-E.

you could try a mld heat elution at 56C to remove the ab. The docs are going to treat the +DAT regardless of the etiology. If the ag sites are blocked by anti-D your DAT would be a lot stronger than 1+. Could also be a private ag from the father.

Why are you doing all of this testing?

Even though we are inspected by CAP and don't see JC much, I can still use them as a weapon encouragement for cooperation from nursing in meeting my regulatory requirements. Every couple of years someone from nursing education asks me why they have to do training for recognizing transfusion reactions and transfusion policies (like YIKES...they can't see the value...Really!!!) and I tell them it's for regulatory compliance, starting with JC. It's unfortunate you aren't getting support from your own department leadership. If JC does a tracer on a unit of blood, you may get nailed (hopefully sooner rather than later, for your patients' sake) - not a bad thing because that will drive change.

Hi sschwartz, The very best reference I can give on this is an Editorial by George Garratty (not a bad serologist!!!!!!!!!) entitled, "How concerned should we be about missing antibodies to low incidence antigens?" from Transfusion 2003; 43: 844-847. Although this is, obviously, a bit old now, the situation has not changed in the intervening years, as far as I know.

He does that too !!!!!!!!!!!, very skilled, our Lord Needs!!!!!!

Hello Malcolm, Please do not give more work to Cliff! If you have a cell phone you can play games on FB!!! :)