Yanxia

Maybe it is too easy, I need some help.

Rh23 is a low frequent antigen expressed in some weak D type blood. In an assay I read it expressed in CCDEE phenotype, but this is not a kind of weak D. What is the name anti-Dw( anti-Rh23) comes from?

I think we may take drug induced hemolysis into account. There is a link http://www3.interscience.wiley.com/journal/71009042/abstract If the patient had been found is DAT positive before transfusion, maybe treat it earlier . If duration between the T&S and the transfusion is too long, during this period the patient receive some drug, the antibodies status maybe change.

I have some questions, would some friends kindly help me to resolve it.The patient is D pos,would give him or her Win-Rho destroy his own red cells? What is the purpose of this therapy?

Sorry, my English is not so good, if my understanding is wrong, I beg your pardon. The least incompatible is the least agglutination. I can't understand what is the same of the little pregnant as it, can you tell me?

Some doctor think to transfuse AIHA patients with washed cells because washing can remove allo- protein or something like this, those things can activate the recipients immunization, the factor will let the auto-immune gone worse. Who can tell me whether it is necessary to choise the least incompatible unit for AIHA patients? Thanks advance!

Thanks for your posts. For this kind of patients we usually give the least incompatible units to them. The first unit is the least incompatible one, but the result is not good; the second one is a random one, the Hb is risen. So I think the most important is not the crossmatch but the steroids her been used. The Hb risen is the result of weakened hemolysis.

The doctor insist to transfusion, the patient been given 1 Unit 3 washed red blood cells. After transfusion ,her Hb from 39g/l risen to 55g/l. Although the blood is uncompatible. So I have a question: Is it significant to do crossmatch for the AIHA patients?

In our hospital the Hb result is within 24 hour to order transfusion.

We meet a patient, her diagnosis is AIHA. We can't get the specificity of her autoantibodies.Fortunately she have not alloantibodies. Yeaterday we give 1 unit of 3 washed cells to her(not compatible), the Hb fallen . Today the doctor want 1 unit again, what can we do?

can you exclude auto-antibody?

To grade the mix field we can differentiate A3/B3 to Aend/Bend subgroup, and when a type A patient been given type O cells ,if not too much,we can see the anti-A agglutinate lots of cells instead of a few of cells which will reflect through the grading report.

We will look A&B antigen weaker than 2+ as weaken, which we will find the reasons, subgroup or illness.

I grade it, too.

Mabel, if my memory not cheat me there has acquired A antigen, it is a kind of T polyagglutination, been agglutinated more strongly in B serum.

Can saline replacement reduce the strength of significant reactivity, I think this is a question.In AABB Technical Manual suggest to use saline replacement to distinguish the real agglutination from rouleaux, I think spin the tube then spill it gently on a piece of glass( sorry for my poor English), then see it microscopically. The rouleaux is stack of cells ,its edge is smooth seems like been surrounded by fibrin or grume.

Thank you, Mabel.

We will use stored less than 7 days cells for cardiac patient, because the better flexible and lower Potassium. I have not read the article in the NEW England Journal.

ROsemary, would you tell me the meaning of "Cold Aggs", sorry I can't find the explaination,thanks!

I think rouleaux and cold auto( titer below 1000 in 4 drgree C) are all insignificant, the question is correct name it, because they are two different reaction.

I guess the baby have ABO HDFN and other type of HDFN. In the newborn's blood stream, the cells with stronger A&B antigens had been destroyed,so it have a temporary balance.The transfused cells destroyed more than the newborn's cells because the adult's cells have stronger A&B antigens than newborn's. Maybe the strong DAT is not due to ABO antibodies.

Bob, can you remember how strong of the ABO HDFN baby's DAT?

The enhanced DAT test will examine the result microscopically. In Chinese people there is not ABO HDN its DAT stronger than 2+ macroscopically, so see your post I feel surprising.

Thanks Mabel! Galvania, you have seen 2 cases of ABO HDN ,the DAT of the baby was strongly positive.That is so strange to me to hear that. Did you do the enhanced DAT test?

It is my pleasure.