yan xia

we will not transfuse in this situation

i am sorry if my understanding is wrong. Do you mean if the salin panel result is neg, you will not do adsorption test even the enzyme and PEG/LISS panel results is pos? I think it is not safe, because most allo -antibodies are IgG, they are non reactive in saline.

and from my daily work, i find we can tell from the proportion of cells, if transfused is less, then on the mix field result, the large part is the patient's own cells

there is a method which using a microtube( sorry, i am not sure how to call it), fill the tube with blood, then centrifuge it, the new generated red cellls are lighter so they are on the upper layer, they are the patients' own cells, the transfused cells are heavier, so they are on the bottom

It seems a weak anti-D which is sometimes too weak to show up on enzyme technique. Maybe the former several pregnancies immune the lady.Maybe knowing the kids D type will help.

i cannot remember we do in-dated panel cells QC in the reference lab use antiserum . Just as Debbiel mentioned the panel cells must be visually qualified. we use them to do antibodies identification, then get the result, use reagent antiserum to confirm the antigen is absence on the auto cells if DAT is neg( if we have those reagent), then use two antigen pos cells and two antigen neg cells to confirm the antibodies again. the panel cells express a lot of antigens , some of them are rare and it is hard to get the specific antiserum, i think it is hard to QC those antigens during the life span of the panel.

The patient is AB, I don't think the transfused Rbcs are the problem. Maybe because the A platelets with high titer of anti-B or the patient's blood volume is smaller than normal adult. I think do an elution is good to prove what is on the red cells, there are lots of ABO HDFN has neg DAT, but pos elution.

The patient is AB, I don't think the transfused Rbcs are the problem. Maybe because the A platelets with high titer of anti-B or the patient's blood volume is smaller than normal adult. I think do an elution is good to prove what is on the red cells, there are lots of ABO HDFN has neg DAT, but pos elution.

Maybe the anti-B is just room temperature reactive, the transfusion is safe. And what if he or she receive an AB donor kidney...

Thanks again Brenda for sharing this case with us. I just wonder if at first we use the Erytra (Automated Grifols GEL) , it gives a good result as AB, then this patient received AB red cells, what will happen?

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.

I guess the antibodies come from the donors. And the antobodies are against low infrequency antigens on the recipient's red cells, so" the eluate did not react with the transfused RBC...and the panel cells..."

enzyme treatment may enhance the Rh system antibodies reaction, maybe it can help