Mosaics

We did this in gel. I repeated it in tube and got the same results. We did not change our anti-A reagent.

I have an interesting case study for y'all that I had at work today. Patient results: Anti-A 4+ Anti-B 4+ Anti-D 4+ Rh control 0 A1 cells 3+ B cells 0 We have the patient history as a B positive in the computer. What do you think is the cause of these discrepant results and what would you do to resolve?

(1) Do you retype the patient's ABO/Rh if there is no historical blood group? We use gel and tube methods. We use gel to first get the ABO/Rh Reverse type, then we redo types, forward typing only, in tube on same specimen. We especially repeat this procedure on cord bloods because not all weak D's are picked up in gel method. If the doctor has ordered blood on the patient, we ask for another specimen to be drawn to verify blood type (we do in tube, forward typing only). (2) Do you recheck the donor blood with a segment attached to the blood bag? Forward typing only. We only do D on Rh negative blood. (3) In case of massive transfusion, and running out plasma in the sample tube, would you shift back to unmatch using Group O red cells even the patient is Group A or B? I have not come across this too often. (4) How do you issue blood to neonate? Since you might not have sample to do immediate spin? We have O negative blood that is CMV negative, irradiated, and sickle cell negative blood for neonates. We make aliquots when the doctor orders blood, and only do crossmatches if mother has antibody.

What is your hospital's procedure for dealing with IgA deficient patients? Do you have the providers prove that the patients are IgA deficient by the most sensitive testing methods, and/or have the antibody to IgA before ordering products such as IgA deficient plasma? Also, what is your procedure for washing platelets? What sort of testing does your facility use for testing for IgA deficiency?

We do saline replacement.

At the hospital I work, homozygous cells are preferred for rule outs but if we can't find a homozygous cell, we generally use three for all heterozygous cells or so I thought. Yesterday, a co-worker tells me that we don't use 3 heterozygous cells because Kell doesn't show dosage. I am concerned because I looked it up in a textbook and Kell occasionally shows dosage. My question is not a who is right, who is wrong situation, but what I would like to know what is your procedure at your hospital? I also want to be certain because I want to be safe. Yes, I am fairly new to the field - 6 months experience. Thanks!

I check microscopically when I believe I see rouleaux. I was seeing a lot microscopically, but think I was overcalling it.

In your hospital, do you give rhogam to weakly D positive mothers without differentiating whether the mother is weak D or partial D?