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1) The original antibody ID matched an anti-D, as did the eluate. 2) Just one source for anti-D testing. Its a poly-monoclonal blend. and... We are pretty sure the gentleman has NOT had any Rh immune globulin. Genomic testing is, indeed in process, as we have sent the specimen to our reference lab. The forward reaction with anti-D was a strong and clear 4+. A partial or weak D is unlikely. The rest is being processed at our reference lab this week. I will post results here... Scott

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Hello, Scott, I have a few questions about this case. 1) What is the eluate result that "matched the original antibody ID"? Is it panagglutination or anti-D in eluate? 2) How many sources of anti-D did you use to type your patient? We use up to 3 or 4 sources in this lab if we have such problem in this lab. Here are the things that I usually do to figure out if anti-D is that of auto- or allo- .. 1) exclude the possibility of RhoGm or IVIG adminstration 2) Perform D typing on the patient's red cells using different sources of anti-D. (we usually have 4 or 5 s

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After a lot of reading and deliberation, here is what we ended with. Testing of Male Patients and Female Patients ≥ 56 Interpret according to Rh Tube Test SOP. Follow discrepancies as outlined for women below, except for sending for molecular testing. Testing of Female Patients < 56 For newly tested women less than 56, if result is 0, testing is complete. If > 0 but < 2+, interpret as Rh neg and perform Rh molecular testing. Notify a supervisor to have molecular testing performed. If ≥ 2+, interpret as Rh pos. This is for all women less than

It was a bit of a troll question. It seemed to me that if we can't trust the reactions we get in gel then what's the point of using it. As far as I can tell regarding the IFU's Dansket is right. I realize the importance of precision and care being taken in the blood bank, but I think a lot of times we fall victim to an overabundance of undue caution.

Excellent, and thank you. Very helpful. Here was my takeaway: Therefore, we recommend that samples yielding an IS tube test cutoff score of not more than 5 (i.e., ≤1+ hemagglutination) or a score of not more than 8 (i.e.≤2+ hemagglutination) by gel technology, be considered D– for the purpose of transfusion and Rh immune globulin prophylaxis.

I suppose if you are dealing with a cold-M (with positive reactions in gel) that you later successfully warm-away with tube testing, you could consider the antibody screen negative, when technically you would have a positive gel screen to begin with. But this is not the same as reporting a "positive" screen as negative! Scott

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