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Standard method for isoheme titers?


DPruden

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On 6/1/2023 at 2:42 PM, DPruden said:

Does anyone have a reference for manual isohemagglutinin titers?  I can't find one on the AABB website or in the technical manual

For the manual isohemaglutinin(naturally occurring antibody) titration procedure,  I attached the AABB method for it. Also the AABB method for early detection of hemolytic disease of the newburn. These procedures are from the current AABB methods manual.

Method_3_15_manual_titer_procedure.docx Method 5_3_Titer_for_HDN.docx

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I was looking for a standard method for IgM titers of anti-A and anti-B.  Our BMT floor requests both IgG and IgM titers often.  The only methods I can find are for the IgG anti-A and anti-B primarily for pregnancy which is not concerned about IgM.

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14 minutes ago, DPruden said:

I was looking for a standard method for IgM titers of anti-A and anti-B.  Our BMT floor requests both IgG and IgM titers often.  The only methods I can find are for the IgG anti-A and anti-B primarily for pregnancy which is not concerned about IgM.

Why do they want to know the titre of IgG anti-A or anti-B?  It has been known for decades that the titre makes no prediction of the severity of ABO HDFN?  The only real predictor is that the foetus/newborn will suffer at the same gestational period, or earlier, than the previous pregnancy, and to the same extent, or worse, than in the previous pregnancy.  The problem comes with the first pregnancy, but, as titre is not predictive, surely it would be sufficient for the doctors to know whether or not IgG ABO antibodies are present in the maternal circulation in the first place?

I realise the IgG ABO titre is very relevant in solid organ transplants and stem cell transplants, or have I missed something?

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I've attached copies of our procedure and our worksheet.  Our Heme/Onc docs also order them on our patients post-transplant, and we occasionally get them ordered on kids where they suspect some sort of immune deficiency disease.  

TO-310 Isohemagglutinin Workup - Test and Titer__uncontrolled_copy (2).pdf TO-310F01 Isohemagglutinin Test and Titer Worksheet__blank_copy_id_8428444.pdf

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