Malcolm Needs

I'm not saying anything more - yet!!!!!!!!!!! :D:D:D:D

You may be correct. You may not be correct. I'm not saying yet. But, one thing I did ask was, what further tests would you do to prove/disprove your theory? I COULD GET USED TO THIS FEELING OF POWER!!!!!!!!!! :crazy::crazy:

The honest answer is both yes and no. It rather depends upon the antigen such an antibody could be directed against, and whether it is expressed equally on all red cells, such as the Wr(a) antigen of the Diego Blood Group System tends to be, or whether, like the P1 antigen for example, there is a marked difference in expression from one individual to another. A classic case of this variation in expression can be seen with antigens within the Knops Blood Group System. The probability, as opposed to the possibility, is quite low, I will freely admit, but that having been said, there is evidence that many individuals seem to produce antibodies directed against a whole range of low incidence antigens, with little or no apparent stimulation (which actually suggests that the antibodies may be directed against an epitope that is carried by more than one antigen specificity). If this donor does express a low incidence antigen (and it is a big if), then there is the possibility that the patients may all have produced an antibody against this "common" epitope, rather than an antigen specific epitope. However, all that having been said, there are other explanations for this compatibility problem that have been put forward by other posters that are just as likely, if not more so. :)

I should, perhaps, point out that this is by no means a perfect method, but purely indicative. Testing for the Duffy antigens, for example, that are polypeptides, does not guarantee that such antigens as ABO, which are, essentially, carbohydrates, will survive on the red cells to the same extent, and testing the Duffy antigens does not guarantee that other polypeptide antigens, such as Rh, will survive on the red cells to the same extent. That having been said, it may be better than nothing. :):)

I will start by admitting that I don't know the answer, but it could be that your patient has developed antibodies against one or more of the antibiotics that are in the liquid suspending the red cells (and which may even be coating the red cells), and that the act of washing the screening cells gets rid of the antibiotic. This is only a thought, because I have seen patients with such antibodies that react with screening cells suspended in an Alsever's solution (never sure of the spelling - indeed, I'm never sure of any spelling!), but do not react with the same cells suspended in DiaMed Diluent2. :confused::confused:

Well, I said I'd give it 7 days, but no, we did repeat the tests just in case of human error, and the results were the same. :):)

I agree with you entirely. :mad::mad::mad:

We do not accepted truncated forenames (or surnames come to that) even in the case of lbela printed at the bedside unless we have a written and signed statement that this is because there are only a certain number of characters allowed by the computer producing the label (except in a dire emergency). Otherwise we would require a hand written sample. This very rarely happens anyway, but you can bet your bottom dollar that when it happens it will be when our own computer is also down, so we have to hand-write the compatibility labels, and it is someone with, for example, a Sri Lankan name who is having a liver transplant (I have a great mate from Sri Lanka who has 17 letters in his forename and 14 in his surname)! :eek::eek:

We had a nice little problem in over the past week. It was a pregnant lady in her early 20's, who gave a forward result of 4+ with anti-A grouping reagent, 0 with anti-B grouping reagent, but with a 0 result with both A1 and B red cells against the lady's plasma. All tests were carried out in DiaMed gel at, give or take, 22oC. I can think of 4 explanations for this, but what do you think, and what further tests would you do? I'll give you a few days (7?) to have a think. :confused::confused::confused:

Oh blow it Terri; when I read your heading for the thread, I thought you were talking about my Laboratory, not a computer programme!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! :devilish:

I think you are right Brenda, because I thought it was Solvent Detergent! I have also been very remiss, because I have not yet found out what I promised to find out (and I'm off tomorrow "creating a masterpiece" - well, writing a lecture - so it will still be a couple of days before I can keep my promise). :o:o:o:o

Your train of thought seems perfectly logical to me Heather. By the way, if you want to read more about ABO, there is a fantastic review by Jill Storry and Martin Olsson. It probably wouldn't help in this particular case, but it is well worth a read. It is Storry JR, Olsson ML. The ABO blood group system revisited: a review and update. Immunohematology 2009; 25: 48-59. :D:D:D:D

Welcome Craig.

NO, NO, NO! That was NOT what I meant by my post. Please keep posting, for your sake and everybody else's sake. I've learned a great deal from your posts. :eek::eek:

We've just had two cases of a unit clotting (same patient), and I also know of one in the north of England, where it would appear (in fact, definitely, for the one in the north of England) that the unit was taken down to below the level of the canula in the arm, allowing the patient's blood to flow back into the unit, where it clotted. The one in the north of England was proved by grouping the unit after the clot, and it had mixed-field reactions that included the patient's own minor blood groups. Our two have been sent off for DNA work. In both case, surprise, surprise, the nurse looking after the patient denied that this had happened (in the case in the north of England, it happened when the patient went to the bathroom). :eek::eek:

I sorry Lara, but I have to disagree. As I understand it (IF, indeed, I understand it - ant it's a very big IF), only a group A individual can have acquired-B. The acquired-B antigen is caused by the action of certain bacterial exudates that de-acetylate the terminal immunodominant sugar residue of the A antigen, N-acetyl-D-galactose. A group O individual does not have this terminal immunodominant sugar residue. As I say, I'm not absolutely sure about this (but pretty sure), so don't hang me if I'm wrong!!!!!!!!!!!! :redface::redface:

I agree (although, as I say, if I do come across as patronising and condesending, I apologise and would like members to send me private messages to tell me when I have come across like that - and tell me to get off my high horse)! :redface::redface:

Presumably, however, the screen was IAT at 37oC, whereas the reverse group would have been at (approximately) room temperature? I may be worthwhile putting up a screen/panel at room temperature, just to see. Of course, it may be something quite different, but it's probably worth giving it a go. :):)

I didn't think I was being condesending or insulting, but if I was I apologise. Please, if I my posts ever appear to other members like that, please let me know. :eek::eek:

I obviously don't know, but it could be something as simple as the donor having a "naturally occuring" "cold" antibody in his plasma, such as anti-M, and your B reverse cells being M+. We see this quite a lot in our Reference Laboratory. Did you run a panel on the donor's plasma to see if there was a specific "cold" antibody present? :confused::confused:

In the UK, we are "governed" by BCSH Guidelines, and these state that there should be a correctly spelled forename, correctly spelled surname, a full Date of Birth, a Hospital or NHS Number, the date the sample was bled and the signature of the person doing the bleeding. In the case of an unconcious, unknown patient, or in the case of a major incident, we are allowed to accept "Unknown Male" or "Unknown Female", with a Hospital Number (that must stay with the patient throughout their own stay in hospital) or a Major Incident Number (that must also stay with the patient throughout their own stay in hospital), the date bled and the signature of the person doing the bleeding. In the case of a dire emergency, when getting a second sample would take too long, we have to have a written medical concession (although, of course, some of these are written after the emergency is over). It is all pretty strict. :):)

To be perfectly honest Mabel, I don't know why it happens; I just know that it does! That having been said, the phenomenon only lasts for a short while, and so I would think that it must be some sort of reversable storage lession. :confused:

Hi JulieB and first of all welcome to this fantastic site. I've been in blood trans fusion (mostly blood group serology) for approaching 40 years, and, believe me, I've learned so much from this site since I joined that it is just amazing. The people who post here are just so generous with their knowledge. I will try to help you as much as I can, but we all may appreciate just a little more detail as to how we can help you. I agree that, although deep theoretical knowledge of transfusion and serology is useful, but it is not everything, particularly in these days of the need for quality in all things (not a bad thing, but, sometimes, a bit overwhelming). Your best bet for getting help is to ask more specific questions, and I am absolutely certain that one or more of the members of this site will be able to give you an expert answer in words that you will understand; and, if you don't, will be willing to put their answer in another way until you are able to understand. The people on here are so friendly; again, I say welcome. :D:D:D:D

Agreed. :)

I'm sorry, but I think this post is grossly unfair and unnecessarily rude and personal. If you go to L106's page, you will see that you are able to access all the posts written by her, and you will see that the vast majority are well-written and very informative, and I, for one, have learned a great deal from what she has submitted. :angered::shakefist:shakefist:slap: