yan xia

Have this patient been transfused ? If it had, then maybe the allogentibodies coated with transfused cells, then caused the pos DAT, which would show mixed field . Or the autoantidies are weak, they can only coated with red cells, no free autoantibodies showed on the circulation, then they will not interfere with the crossmatch and screen.

you said the baby is AB type, so the A or B donor must be washed. Because the plasma will react with the red cells of the baby's.

1.I prefer to use O washed blood cells for neonate less than 4 month old 2.one donor 3. one donor is best, but it kind of difficult to do , since the plasma after thawing has shorter shelf life than red cells components

I prefer to call it an A subgroup. Maybe some human anti-A can do help, since it is polyclonal, not monoclone as our reagent anti-A.

The patient received 1250ml o neg packed cells , after the last transfusion, the D antigen buzztest of this patient was 4+, where was the transfused cells? Have it been destroyed by the antibodies? sorry for my dizzy buzz after the night shift. I have noticed the initial Gel test result is D 4+ which is the same as the after 23 days test in Gel.

I guess irradiation can inactivate the lymphocytes, but not deprave the antigens it takes, so it can not replace leukoreduction.

Maybe you can adsorb the anti-e with ccee cells, then to see if there are still reaction with Ce cells, then you can figure out if there are anti-C here.

Thank you very much for the explanation. Just a little confusion how do the Ca++, Mg++ and Mn++ ions infect the agglutination? does it because the complements can enhance agglutination or because the complements caused haemolysis is a sign of ABO mis-match?

Would you explain this please? Thanks

Thanks Malcolm for your wonderful explanation. what is two-stage indirect antiglobulin technique, does it mean we add extra complements from fresh serum? I remember some method like that, but I am not sure about the name.

I remember when I was as an intern in Micro department, there were a lot of specimens, some sent there to do direct organism tests using the dyeing technique under a microscop, which was quick but not so sensitive. So most of the specimens needed to be cultured for 24 hours to see what will happen. I will report positive in this case.

I think this phenomenon is because the B antigens are not well developed on new born baby. BTW, I prefer to use 3+mf to describe it The reason I don't use 4+mf because 4+ agglutination is a kind of solid agglutination, without free cells .maybe I was wrong, just personal opinion.

Yes, we use this kind of method to determine if there is ABO HDN present, putting the elution with reagent A,B,O cells respectively in the refrigerator( 4 degree C) overnight, then gently tip the tubes to see the agglutination. The O cells is as a negtive control, in case there are other cold antibodies interfere with the test.

Sorry, it was my mistake. I am very sorry.

Maybe it is some kind of combined antibody, such as anti-Alea?