I would like to respond since I am a senior tech at the IRL who did the ID on the patient in question. Of course, we follow the AABB IRL guidelines when identifying a specificity. The patient in question also has anti-E, -S, -K and -Fya in addition to the –Cw, -V and –Dia mentioned previously. This patient has made all of the commonly encountered allo antibodies that we would expect with his phenotype. He has a history of GI bleeding and has had multiple episodes at various local hospitals dating back to 2005. We often fill his requirements from our Ro phenotyped inventory due to his antibody history. As can be assumed, most of our Ro donors are either African American or Hispanic and therefore it is not unlikely that the patient has been exposed to the V and Dia antigens. Since the patient does not require C negative units, exposure to the Cw antigen is also not unexpected. As we test this patient in the future, we will likely identify other antibodies to low incidence antigens as these happen to be on selected cell panels. I would imagine that other reference lab staff would agree with me that we do not identify these specificities as a whim. Once identified, we are faced with having to decide how to handle them every time we get new requests for red cells. Julie