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So we sent this to our Reference Lab and they are still trying to figure it out. They ran additional B cells and those were also reactive, so likely not a Low. Also ran mini-cold panel and A1 cells were reactive at 4C only. Patient is A1 Negative. Patient Reactive with several Anti-B Reagents. They do not use GEL so all of this is tube testing, but they did duplicate our results. Patient has Glomerulonephritis and is Asian. The lab is going to try to test with some human antisera.....but may recommend molecular testing IF the physician really has to have a blood type (we could not reach Physician's office for more details Friday but will call today....I thought perhaps they ordered blood type because patient possible kidney transplant recipient in future.....but don't know for sure). I will also pass on your suggestions to the lab as I think they are also stumped. I really appreciate your input and will keep you posted. If physician does not require definitive blood type, we will probably just restrict her to O RBCs and AB FFP and "call it a day." Brenda

The phlebotomy competency checklist from the SHOT info is very similar to what we are currently using.

If the reverse typing use the same A and B cells, then the differ between gel and tube are caused by the methods, otherwise, it maybe caused by low antibodies against B cells in tube method. To verify it, we can change to another B cells to test in tube method. I tend to agree it looks like an ABsubgroup, on my daily use of gel, I find it is not as sensitive to detect reverse reaction as tube method, I guess that is the cause of no reverse reaction on gel but has reaction in tube.