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Posts posted by Yanxia
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How about give them the washed RBCs?
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Maybe choloroquine phosphate can help to remove the IgG antibodies on the cells surface. And heat elution (45 degree C 15 min or 56 degree C 10 min) can do some help to remove IgG antibodies, but not as effective as to IgM antibodies.
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yes, it can. Because the PH of the salin is in larger span than the diluent which maybe PBS .And the reaction's best PH is in the diluent.
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6 hours ago, dothandar said:
Hello. sorry about the delayed reply. We worked further on this case and turned out the pooled AB plasma that we have frozen did not react with neuraminidase-treated cells (another aliquot of NeuNac treated cells) but fresh AB plasma did. We did test this patient's cells with fresh AB plasma and got a positive reaction. We have to try not to used frozen/thawed AB pooled plasma for this test in the future
why the frozen/thawed AB plasma not react with the treated cells?
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We usually do test a specimen when we admit a patient the blood type, then inpute the result into the computer, where through network the doctor can see the result.When they ask for blood , they will write the first blood type result on the sheet, then we will recheck it through a new specimen for transfusion crossmatch.
Sometimes the first result is wrong due to wrongly specimen collection or other reasons, but most of the time it is right, and through this kind of process, we can find out the D neg blood type early( which is rare in Chinese Han people) and AB subgroup blood early before the blood application.
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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.
- Malcolm Needs, JasonS, MinerJ and 1 other
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16 minutes ago, sherif said:
if group A or B must we wash it to remove the plasma or not ?
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.
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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
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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.
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I guess irradiation can inactivate the lymphocytes, but not deprave the antigens it takes, so it can not replace leukoreduction.
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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.
- MaryPDX, rravkin@aol.com, exlimey and 1 other
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On 2018/1/11 at 3:30 PM, Malcolm Needs said:
It is because serum would have Ca++, Mg++ and Mn++ ions present (needed to activate the classical complement pathway beyond initiation), whereas EDTA will, in effect, remove these ions from plasma by chelation.
An ABO mis-match is far "easier" to detect using serum than plasma, and may even lead to haemolysis of the test cells, however, in both cases, IF the plasma of the proposed recipient has high levels of Type 1 ABO antigen (the ABO substance that is soluble in the plasma/serum - in other words the proposed recipient is a "strong secretor"), there is a slight danger, albeit slight, that this ABO substance may inhibit the reagent anti-A and/or anti-B, causing false negative results.
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?
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14 hours ago, R1R2 said:
Don't know if someone mentioned this idea earlier, but did you try serum? Reactions may be inhibited or weak if using EDTA plasma.
Would you explain this please? Thanks
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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.
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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.
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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.
- Malcolm Needs, galvania and exlimey
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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.
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14 hours ago, Malcolm Needs said:
I have heard of anti-ALeb, but not of anti-ALea. I would have thought that, if it was a case of anti-ALeb, it would have reacted with more examples.
Sorry, it was my mistake. I am very sorry.
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Maybe it is some kind of combined antibody, such as anti-Alea?
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This is a complicated case. Are the screening cells reacting very good ( I mean does it have neg reaction) with other patients' sample?
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it is a long post to me
the first one, i often see B antigens are weaker than A antigens on our newborns, but ont as weak as 1+, i think it maybe an ABsubgroup.
the second one,"Lutheran antibodies have not been implicated in immediate haemolytic transfusion reactions, although they may have been responsible for mild delayed reactions and post-transfusion jaundice."I think the symptom after transfusion fit it.
Geoff Daniel, Human bloog groups,second edition, 279,230
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?
group O RBCs for non O neonates
in Transfusion Services
Posted
I think washed out the plasma and freed K+ is safer to newborn, and it is not too expensive, just 20 yuan more than the packed cells. And if do the anti-A, B titre in the packed cells is also time consuming and money consuming. Just my personal opinion.