Jump to content

Recommended Posts

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?

Share this post


Link to post
Share on other sites

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:)

Share this post


Link to post
Share on other sites
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.

Share this post


Link to post
Share on other sites
Posted (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 by exlimey
Typo

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Advertisement

×
×
  • Create New...

Important Information

We have placed cookies on your device to help make this website better. You can adjust your cookie settings, otherwise we'll assume you're okay to continue.