Malcolm Needs

I CANNOT tell from the information you have given (not least because the phenotype of the reverse typing cells and the panel cells are unknown to me). I would very strongly suggest that you send samples to a Red Cell Reference Laboratory to get this sorted out, BEFORE the patient needs a transfusion in an emergency. From what you do tell us, I think the antibody/antibodies are unlikely to be fatally clinically significant, but it depends on the true specificity/specificities and the underlying pathology.

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I tend to think that there are a number of factors affecting the reaction, such as changes to the pH, rather than just dilution, that would change the equilibrium constant within the Law of Mass Action that governs antibody/antigen reactions, but pH is only one of them.

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Are you looking for really difficult cases, or more commonplace cases?

It looks like an A subgroup B to me. The apparent reaction with the A cells and the donor's plasma in the reverse group in the first photograph could be a weak anti-A1, but more likely it is another specificity altogether (such as an anti-P1). Without a doubt, however, a sample from the donor should be sent to a Reference Laboratory to have the ABO type sorted out (e.g. by adsorption and elution tests, preferably using a strong human-derived polyclonal anti-A). Nice crisp photographs, by the way.

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A research team led by NHS Blood and Transplant scientists based in Bristol, at NHSBT’s International Blood Group Reference Laboratory (IBGRL), and supported by colleagues at the University of Bristol, has discovered a new blood group, MAL. 🙌 🩸 They identified the genetic background of the previously known but mysterious AnWj blood group antigen, thus allowing identification and treatment of rare patients lacking this blood group. Louise Tilley, Senior Research Scientist, IBGRL Red Cell Reference at NHS Blood and Transplant, said: “The genetic background of AnWj has been a mystery for more than 50 years, and one which I personally have been trying to resolve for almost 20 years of my career. It represents a huge achievement, and the culmination of a long team effort, to finally establish this new blood group system and be able to offer the best care to rare, but important, patients." hashtag#NHSBT hashtag#GiveBlood hashtag#SaveLive hashtag#NHSCareers Activate to view larger image,

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