fendi98 Posted May 9, 2019 Share Posted May 9, 2019 Hi everyone, Patient is pre-op, never been transfused as far as the bb is aware. O neg, rr K- phenotype Negative panel by IAT and enzyme card technique, LISS IAT negative as well. Auto neg. 3 units crossmatched (Oneg rr K-) and performed by IAT card technique = compatible Saline tube technique at 37, immediate spin = incompatible with 1+ reaction including auto control I repeated the saline tube with fresh suspension of red cells but got the same reaction. I thought maybe there's a cold antibody so I also performed a saline panel at room temperature by card and got negative results including neg auto. Any thoughts? Link to comment Share on other sites More sharing options...
Ensis01 Posted May 9, 2019 Share Posted May 9, 2019 Did you try saline replacement at IS and 37? JasonS 1 Link to comment Share on other sites More sharing options...
Yanxia Posted May 10, 2019 Share Posted May 10, 2019 Because the 37 degree C pos result was in tube, I thought maybe the room temperature saline reaction using tube will be better to interprete the result.Because card and tube are two different methods. Just personal opinion Malcolm Needs 1 Link to comment Share on other sites More sharing options...
Malcolm Needs ☆ Posted May 10, 2019 Share Posted May 10, 2019 10 hours ago, fendi98 said: Hi everyone, Patient is pre-op, never been transfused as far as the bb is aware. O neg, rr K- phenotype Negative panel by IAT and enzyme card technique, LISS IAT negative as well. Auto neg. 3 units crossmatched (Oneg rr K-) and performed by IAT card technique = compatible Saline tube technique at 37, immediate spin = incompatible with 1+ reaction including auto control I repeated the saline tube with fresh suspension of red cells but got the same reaction. I thought maybe there's a cold antibody so I also performed a saline panel at room temperature by card and got negative results including neg auto. Any thoughts? My first thought is, how on Earth do you make sure your immediate spin saline tube technique at 37oC is strictly at 37oC (or have I got that wrong, and you are doing a saline tube technique at 37oC and an immediate spin at room temperature in addition; and, if so, were both incompatible?). My second thought was, if the patient has not been transfused (as far as in known), you know his ABO, Rh and K type and the cross-match was compatible by IAT card technique, why did you perform the panels by IAT and enzyme card technique AND LISS IAT and, having found these negative too, why did you perform the other saline techniques? I just do not understand. It seems a huge amount of unnecessary work just to find a weak auto-antibody. applejw, exlimey, SMILLER and 4 others 7 Link to comment Share on other sites More sharing options...
exlimey Posted May 10, 2019 Share Posted May 10, 2019 (edited) 13 hours ago, fendi98 said: Saline tube technique at 37, immediate spin = incompatible with 1+ reaction including auto control I concur with the autoantibody conclusion. However, unless you've neglected to tell the forum important details about this case, this work-up should have stopped at a negative antibody screen (in cards). I'm more concerned about why are you doing lots of extra work - especially an enzyme panel. And, why, oh, why are you using a "primitive", "insensitive" tube test when the super-sensitive card tests are negative /compatible? If this is a "normal" work-up, I believe your testing algorithm needs attention. Edited May 10, 2019 by exlimey Typo Yanxia, Ensis01, John C. Staley and 4 others 7 Link to comment Share on other sites More sharing options...
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