Tessa

Andrew Hadley and Peter Soothill (Editors).  Alloimmune disorders of pregnancy.  Anaemia, thrombocytopenia and neutropenia in the fetus and newborn.  1st edition.  2002.  Cambridge University Press.  ISBN: 0 521 78120 5.

Failing that, send them back to Nursery School, because it is THAT simple!

There is absolutely no reason to give group O red cells to a recipient who is A3.  Even if the patient does develop an anti-A1, unless that antibody is reactive at strictly 37oC, they can still receive A1 red cells, but, if the anti-A1 does react at 37oC, there is no reason not to transfuse with A2 red cells that are IAT compatible.
Personally, I have never seen loss of A or B antigens through ALL, but I have with AML.  In fact, in one case, we were able to follow whether the patient was in remission or relapse by the strength of the reaction of the A antigen with various anti-A reagents, but this was many years ago, and I honestly can't remember whether these were human-derived polyclonal reagents or early monoclonal reagents.

Sounds like total rubbish from both a clinical and scientific viewpoint. Another instance how the administrative/legal model of reality is undermining civilization :).

Yes, when there isn't a true massive, it is more likely the patient may make an antibody. That said, we have the same procedure here as you Kym: we give O pos to males and women over childbearing age for ANY emergent release red cells. If they only get 1 or 2 units, then so be it. This is part of the battle of using inventory appropriately and calling a code/massive appropriately....and never the twain shall meet.....  

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