Malcolm Needs

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Arndt PA, Garratty G, Marfoe RA, Zeger GD. An acute haemolytic transfusion reaction caused by an anti-P1 that reacted at 37 degrees C. Transfusion 1998; 38(4): 373-377. DOI: 10.1046/j.1537-2995.1998.38498257376.x. Smith D, Aye T, Er LS, Nester T, Delaney M. Acute hemolytic transfusion reaction due to anti-P1: a case report and review of institutional experience. Transfus Med Hemother 2019; 46: 381-384. Published online as DOI: 10.1159/000490897. Irani MS, Figueroa D, Savage G. Acute hemolytic transfusion reaction due to anti-Leb. Transfusion 2015; 55: 2486-2488. DOI: 10.1111/trf.13178. Delk AA, Gammon RR, Alvarez H, Benitez N, Bright F, A hemolytic transfusion reaction caused by an unexpected Leb antibody. Laboratory Medicine 2021; 52: 303-306. DOI: 10.1093/labmed/lmaa070.

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Welcome to this WONDERFUL site newlab. ENJOY!

I'm sorry Neil, but Geoff Daniels quotes some HTR's caused by anti-N reacting at 37oC, and one case of mild HDFN in a M+ N+ baby, where the mother was M+ N-, S-, s- Uvar, in the third edition of his book, Human Blood Groups.

Thank you kjmiller. Could be the doctor is being more cautious/more proactive, but in the UK (and I have only ever worked in the UK) our Guidelines suggest/DEMAND that we give K Negative to a patient requiring chronic transfusion, unless they are K Positive (although, interestingly, they are silent on what to give if the patient is K+k-!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!).

The first thing I would ask is, is the lady pre- or post-menopausal? That having been said, in the UK, we tend to give all patients who are likely to be chronically transfused, K Negative blood, whether they be male or female, unless, of course, they are known to be K Positive, purely because the antigen is so immunogenic. As for your question regarding irradiation, that is much more of a clinically decision (I am not, and never have been a Clinician), but I can't see why the units should not be irradiated,

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In that case, I would consider a genotype, as getting hold of M+ N-, S-s-U- fresh units is not going to be easy. That having been said, as you say yourself, anti-N is rarely clinically significant and, if it is not detectable in either the maternal circulation, or in the baby's circulation, I wouldn't worry too much about giving M+, N-, S-s-U- blood. BEAR IN MIND THOUGH, THIS WILL BE A CLINICAL DECISION, AND I AM NOT, AND NEVER HAVE BEEN, MEDICALLY QUALIFIED.

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