Malcolm Needs

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I'll do what I can. I've got a few (about ten or so) I've used in my own lectures that I'll pass on to you with pleasure. For ease, would you trust me with private messaging an email address I could use please? I'll keep it to myself, of course. Malcolm. P.S. It may have to be tomorrow now.

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Oh it is!!!!!!!!!!!!!!!!!

Do you think somebody should tell them that ABO HDFN sometimes gives a Negative DAT result in the fist two or three days of life, and that they might actually be better off looking for clinical signs, rather than performing diagnoses on the result of pathology results???????

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I think that it depends upon the state of the baby. For example, if the mother is D Negative, and has been in receipt of anti-D immunoglobulin, and the baby has a positive DAT, but is showing no other signs of HDFN, then we wouldn't perform any further testing. If the baby has a lowish Hb, and the mother is group O and the baby group A or B, we may take a look at the mother's IgG ABO status, and then perform an eluate on the baby. Where we might really "go to town" is if the baby is showing overt signs of HDFN, we might well go the "whole hog" and perform an elution, just in case there is a maternal alloantibody directed against a low prevalence antigen also expressed on the red cells of the father. If this is suspected, it would be easy enough to adsorb out any IgG anti-A or anti-B on the baby's red cells, without adsorbing out the potential antigen against a paternal low prevalence antigen. The specificity of such an antibody would be interesting, but not necessarily vital, as, should the baby require a transfusion, suitable blood should be easy to obtain.

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