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We have a patient who received many units of group/type specific red cells in Jan. of this year. At that time, his antibody screen was negative. His group and type is A, Rh positive using monoclonal typing reagents. The anti-D reactions have been 2+ and 3+. His current specimen shows an anti-E in the plasma and a panagglutinin in the eluate tested in gel, with stronger reactions in the D+ cells. His eluate tested in tube shows a clear anti-D pattern. Could this be a D variant? Auto-anti-D? Should he get Rh negative red cells? Thanks!