kmmoton

In any of your facilities do you allow nursing staff to pick up blood bank products if they have food or drink with them?  Is there a health and safety guideline that addresses this?

I would like to know what's everyone's take on a patient with an Anti-Jsa. Do you have units screen or do you just XM Extend?  Please explain your answer.

The reason that Jk(a) variants tend to weaken the antigen expression is because of the way the amino acid residue that produces the antigen is very close to the red cell membrane and is"semi-hidden" by the third external loop (see the attached diagram).Kidd Molecule.ppt

I agree 100% with Anna.
We actually see a few of these every year.
The only thing that I would say is that variant Jk(a) antigens are few and far between, and usually result in considerable weakening of the Jk(a) antigen. In this case, your results point to a normal expression of the antigen.

Possibilities:
1.  Auto anti-Jka (have been documented)
2.  The patient is a Jka variant with allo-anti-Jka
3.  Patient has a BM transplant
4.  The antibody is not a real anti-Jka.  (There is a type of pseudo anti-Jka that is dependent on parabens for its activity.  Depending on the method you are using to do your antibody screens, this might be probability no.1)
5.  Something else that I haven't thought of!
To do:
1.  Check patient's records for eventual bone marrow or stem cell transplantation.
2.  If possible, repeat the antibody screen with cells and methods from different manufacturers
3.  Repeat antigen typing and if necessary molecular biology.
In the meantime, and provided he is Jkb+, transfuse with Jka-b+ blood. 
 
Hope this helps
anna

Fresh sample for us on admission. Over the years, I have seen too many patients answer NO to the standard questions and found they have recently been transfused in another hospital "Oh, I though you meant here in this hospital." I have never run a retrospective risk assessment on it though. Might be one for when I am short of work (LOL).
Cheers
Eoin