So, interesting patient last month. We had a patient with a history of anti-e. (not good) Worked her up and every cell on the panel was positive (even the e neg antigen cell). Her auto control and DAT were negative. Come to find out after sending her to our reference lab for a full work up, which then sent her to the American Red cross that she has developed anti-Kpb. She was Kpb antigen negative. She would need blood negative for K, Kpb, e and C (could not rule out big C). After a long search she is not compatible with any of the blood (rare donor databases I am assuming) in the US. If we wanted to start a global search the physician would have to get in contact with the director the ARC directly. It was crazy! We are a small hospital who never sees this kind of crazy stuff, but I guess it was our turn. (The patient is responding to iron treatments and has been doing ok with out blood transfusions thus far.)