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Anti Cob

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Patient has anti Cob reacted by enzymes IAT. Is this clinically significant antibody? Does this patient require antigen negative blood? 

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Anti-Cob has rarely caused a clinically significant haemolytic transfusion reaction, and, even then, the antibody was, in both cases, extremely potent.

An anti-Cob, only detected by papain-IAT is certainly not going to be clinically significant, although when the antibody can be detected by IAT, using red cells that have not been treated with a proteolytic enzyme, then Co(b-) units should be transfused.  In your case, it would be quite safe to transfuse units that are found to be compatible by IAT with untreated red cells.

Geoff Daniels says in his book (Daniels G.  Human Blood Groups.  3rd edition, 2013, Wiley-Blackwell) that anti-Cob is quite a rare antibody and, while I am ALWAYS wary about gainsaying anything written by Geoff, I think that may be more to do with the Co(b) antigen not being expressed on most screening red cells and even on most panel cells because, when they were, anti-Cob was a comparatively common finding in the samples submitted to NHSBT-Tooting Centre's RCI Laboratory when I was Reference Service Manager there.

As you are working in the UK, you might find it useful to read the specification (SPN214/4), issued by NHSBT, "The Clinical Significance of Blood Group Alloantibodies and the Supply of Blood for Transfusion.", written by my good friend Nicole Thornton, Head of Red Cell Reference at the IBGRL.  You can find it on line.

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Thanks Malcolm

RCI suggested xm compatible blood but when I was reading articles, they were saying it's clinical significant, which confused me more. 

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