Rh-fan

On day 10 we also had performed enzym treated cells in anti IgG cards. When only one or a few reactions are found and they are all Jka or Jkb pos, we do that to look for anti Jk antibodies. The most sensitive methode to look for anti Jk antibodies. And also feno- or genotype the patient tot see what can be made.

In the Netherlands since the recent guidelines, we have to select Rh fenotype compatible for al patients that have a (Rh, Kell, Jk, Fy Ss) antibody, to prevent these problems. Maybe I have mentioned this before but we have now a almost nation covering database for the registration of allo antibodies, TRIX. Before transfusion a hospitol have to look in that system (mostly done by the LIS system) to see if the patient is known with antibodies. Since the introduction of the database I have heard a lot of stories (and seen publications) about patients with undetectable antibodies. I think the UK and the USA for sure are to big (to many hospitals) for such a system but in the Netherlands (100 hospitals) it is working fine. Peter

We use untreated cells and take 1 part of serum (600ul) and 2 parts of cells (1200ul). The first to times we incubate for 30 min, then go to 60 min.After absorptiun we use 25ul of serum in the Birad/Diamed gel test.

Maybe they use anti human IgG Fab fragment that bind to the bound IgG. If you then add anti Fya and after washing complete anti human IgG. That sounds like something that could work. Peter

My first thouth was anti BI (anti B only reactive with adult and not cord cells), but the non reactivity of the AB sample confuses me. That exclude anything directed against a B antigen. Was anti Cw excluded, that can reactive at RT and CCDee are more often pos. Just an unlucky draw with the B cells. It would be nice to hear about the follow-up. Peter

We use EGA or do genotyping. How does these 'blocking' works? I have also heard about IgG monoclonals from mouse, and by the use of anti Mouse-IgG (instead of anti Human-IgG) they gave good results. David, W.A.R.M. is the comercial name of ZZAP (or not?), if it is the same as ZZAP then you destroy more than Kell (also Fy, MNS, Lu). Peter

Nice, specialy the fraise "Technicalities only known to chiefs and Malcolm" Almost nothing is changed. Peter

No need for any hospital to perform Du testing on patients. Most of then will be negative and when you found a patient that is postive in Du only you need to treat them as D neg. Is a lot of work and costs and any profit. In the Netherlands it is in the guidelines to determine the RhD antigen of a patient with onl one reagent (IgM at RT). Peter

Malcolm, I found Kuziva (very easy between 2200 other people) and we had a nice talk about that "serology rules".

The ISBT meeting is at this moment in Amsterdam. Are there any forum members there?

Liz, I love to see that ppt when it is ready (even without the singing). Peter

anti LebH will be reactive with the pool of O cells. Anti LebH will reactive with cells that have H (group O and A2) and the Leb antigen. Cells that have Leb but lack (a lot of) H (A1) will not be reactive with anti LebH. The differance between anti A and anti A,B makes me think of Ax. In those patients we se sometimes a very strong anti A1 that also is reactive with A2 cells (better to say anti A instead of A1). The problem is in your patient is the weak reaction with A1 cells. Can you test A1 cells in the same way you tested the different A2 cells? Peter

Has anyone seen this Youtube video? It is a movie about the Lewis system and it is made by Stephen Schilling. He has also made simmilar video's about the MNS, Kell, Duffy, Kidd and Lutheran system. You can also find them on Youtube ( search for 'blood group song' or his name). I specialy like the MNS movie, where M and N are show as a few simple geeks, S, s and U are shown as dangerous criminals. Very funny. A co-worker of my found them and I have planed to use them in future lessons on this systems. Have fun watching the video's. Peter

EGA is nice but in this case it will not help. EGA can also be used to remove HLA antigens (and Kell). The procedure takes more than 10 minutes (instead of 2 hours when you use Chloroquine) In case of allo antibodies against donors cells, the EGA will remove the antibodies. When you then test the eluate again with the patient cells (that contains donor cells) will be reactive. In that case you have to collect/concentrate reticulocytes and test the eluate with those, that is a real autocontrol. As Malcolm mentioned, If transfusion is more the 3 months ago, it must be auto antibodies.