Jesmond

Hi Malcolm Thank you for your reply. I only performed 6 allo adsorptions, until the DAT on the adsorbing cells came negative. In this case our consultant too wanted to play safe and we issued 4 units A rr. Malta is a small country and we do not see much of these cases..... I think most of you would say Lucky them..... but I still enjoy working on them. Once again thanks for your information regards Jesmond

Hi everyone We had a case of a 30 year old female with AIHA and a Hb of 5g/dl. Her EDTA plasma reacted with all screening cells (CAT-IAT) and Identification cells (CAT- IAT and Enzyme). The reactions were all of the same strength; 3+ in the IAT and 4 + in enzyme. The auto control in IAT was also positive. We repeated the screen using the tube technique and monospecific coombs IgG. The screen was positive with all the cells. The DAT with polyspecific AHG was strong positive. Reswults with monospecific AHG were as follows (anti-IgG strong pos; anti C3d weak Pos). The patient was never transfused, blood group A RhD Positive, K negative, and ccDEe phenotype. We performed an warm allo adsorption using R1R1, R2R2 and rr cells. the following results were obtained on the adsorbed plasma. R2R2 - no antibodies detected; R1R1 - anti-E identified; rr - both anti-D and anti-E identified. I have never encountered auto anti-D and auto anti-E together. I was wondering if anyone has had a similar case or could share some ideas and information:o Thanks Jesmond

Hi Malcolm Thanks for your response. Don't worry, it will do. At least I know that each lab can define its own cutoff, and that there is no other guidelines and recommendations. Thank you again for your great help Jesmond

Thanks Malcolm Jes

Hi everyone I would like to ask a question related to the 'Guidelines for compatibility procedures in blood transfusion laboratories' prepared by the BCSH. In section 8.6, The immediate Spin XM, there is written that this technique cannot be used in patients where ABO grouping reveals very weak anti-A or anti-B (except in group AB patients). I would like to know if this weak reaction can be quantified; for example: you cannot use the IS if you obtain a 2+ reaction or lower using CAT. I think that a laboratory should have a standard cut-off reaction to determine which patients can have units allocated by the IS. I would like to know your opinions on this matter. Best regards Jesmond