Abdulhameed Al-Attas

While Rh control must contain every thing that the Anti-D cotains exept Anti-D,I agree that 22 to 30% albumin can be used as Rh control. And that It is very important to use with an AB Rh positive patient.

yes,I agree,while it must contain all that the Anti-D contains exept the Anti-D, The important thing is the 22 to 30% Albumin.

Hi John, I note with interest your trepidations over our use of group O red cells in neonatal transfusion setting; your major concern being that it would elicit a "vicious circle" of hemolysis in e.g. group A neonate with maternally acquired anti-A. Theoretically, your concern would appear to have merit. However in our experience, this is not the case for the following reasons: 1. The group O red cells used are virtually completely depleted of plasma and hence virtually lacks anti-A,B. 2. Any group O cells from donor with high titre isoagglutinins (hemolysins) are excluded for such use except washed and reconstituted in AB plasma. 3. The group O cells are used only for top-up (small volume (< 50 ml) transfusions).

The very little plasma may mean alot for a small child. We never use whole blood in our Blood Bank. I am very proud to say that KAMC- Transfusion Medicine Dep't.is Accredited by both AABB and CAP

What about in neonate Transfusion? We never use whole blood in our Blood Bank. I am very proud to say that KAMC- Transfusion Medicine Dep't.is Accredited by both AABB and CAP.

That is NOT true iam afraid,it's there in AABB Standard Manual. This Anti-A or Anti-B is aquired phenomena,(from the group O units given) it can either be IgG or IgM,if IgG i think it can stay upto 3 weeks and IgM little longer.

1- As soon as patient's plasma is clear of irregular Iso-agglutinin(s),in this case irregular Anti-A Iso-agglutinin. 2- The test that needs to be done perior to this switch-back is testing for Anti-A Iso-agglutinin at the AHG phase. Only when this is negative would switch-back be entertained . Therefore,switch-back is NOT necessarily time dependant.

We can ONLY treat the patient as type unknown in case of first class Emergency. You did NOT mention any emergencies and you had the first sample, all you need is to inform them the importance of the 2nd sample and that you wont issue anything unless the 2nd sample is provided. You can't solve this to that.

Yes,in KAMC- (Transfusion Medicine Dep't),We do perform ABORH and DAT on ALL cord blood samples routinly.Further Evaluations:The DAT is usually strongly positive in HDN due to anti-D or antibodies in other blood groups;however the reactions may be weak or negative in HDN due to ABO.If the DAT is positive,elute and identify the antibody.Compare its specificity to any antibodies identified in the maternal specimen. If the DAT is positive but the maternal serum is antibody-screen negative,either ABO-HDN or HDN due to a low-incidence antigen should be considered.Perform an eluate from the cord blood and test against A1,B and O cells. Even if the DAT is negative and ABO-HDN is suspected,perform an eluate and test against A1,B and O cells using an antiglobulin technique.If transfusion is required,use group O,RH-compatible cells even if the diagnosis is not serologically confirmed. If ABO-HDN has been ruled out,an antibody against a low incidence antigen should be considered.Perform an eluate from the cord blood and test against the father's cells using an antiglobulin technique.Then test the mother's serum against the paternal cells using an antiglobulin technique. If the DAT is positive and all attempts to characterize it have failed ,consider false positive causes for a DAT(RBC agglutination before washing,cotamination with colloidal silica,improperly cleaned glassware,overcentrifugation,improperly prepared reagent with anti-human species antibodies,cold agglutinins causing complement deposition,silica gel contamination,contamination with IV solutionscontaining dextrose in distilled water,T-activation(polyagglutination)from bacterial sepsis).

you are right if you are NOT screening your Donors for irregular antibodies, then you must do the minor crossmatch.