Jump to content

Featured Replies

Posted
comment_91192

Hi 

We Received URGENT request for 1 unit of blood transfusion for 1 year old child who had previous transfusion at abroad due Thalassemia Major. 

This was patient 1st visit in the UK therefore Rh and K phenotype was not known .  As per guidelines Rh and K phenotype performed. 

Rh phenotype results obtained as below

C mf E 4+ c+4 e4+ K mf. (Probably R2r)

Because patients was previously transfused at other country sample was sent for genotype which will take 2 weeks to get results back. 

Due to clinical condition, patient, required urgent transfusion therfore with Haematology consultation 1 unit of blood C-K- blood issued by IAT xmatch.  Meanwhile sample was  sent for Rh genotype and results received  as C+E-c-e+ (R1R1). 

Totally different phenotype result

Why? 

I know patient had multiple  transfusion at abroad.  

But never seen. 

Thankfully we had consultant approval to issue C-K- blood. 

Lesson learned always involve clinical team to decide. 

Any further comments 

 

 

 

Edited by gagpinks

  • Replies 7
  • Views 1.2k
  • Created
  • Last Reply

Top Posters In This Topic

Most Popular Posts

  • We would honor the molecular typing and provide E-, c-, and K- red cells for this patient moving forward.  Your serologic typing results are not valid due to recent transfusion, and this isn't an unco

  • Aah okay, I guess you answered your own question. The mixed field C result is perhaps due to the dual population of blood transfused. Some may have been C+ and some C-. c+ is a common antigen, almost

comment_91275
On 11/7/2024 at 2:01 PM, gagpinks said:

Hi 

We Received URGENT request for 1 unit of blood transfusion for 1 year old child who had previous transfusion at abroad due Thalassemia Major. 

This was patient 1st visit in the UK therefore Rh and K phenotype was not known .  As per guidelines Rh and K phenotype performed. 

Rh phenotype results obtained as below

C mf E 4+ c+4 e4+ K mf. (Probably R2r)

Because patients was previously transfused at other country sample was sent for genotype which will take 2 weeks to get results back. 

Due to clinical condition, patient, required urgent transfusion therfore with Haematology consultation 1 unit of blood C-K- blood issued by IAT xmatch.  Meanwhile sample was  sent for Rh genotype and results received  as C+E-c-e+ (R1R1). 

Totally different phenotype result

Why? 

I know patient had multiple  transfusion at abroad.  

But never seen. 

Thankfully we had consultant approval to issue C-K- blood. 

Lesson learned always involve clinical team to decide. 

Any further comments 

 

 

 

 

May I ask what was the patient's type and screen result prior to any transfusion? 

 

comment_91305

We would honor the molecular typing and provide E-, c-, and K- red cells for this patient moving forward.  Your serologic typing results are not valid due to recent transfusion, and this isn't an uncommon genotype for a thalassemia patient.  Unfortunately this means that the patient received c pos units (when you gave C-, K- red cells), but that was the best you could do without knowing that information before the first transfusion was ordered at your facility.  We come across this frequently with new/relocated sickle and thalassemia patients.

comment_91319

I just can't understand why the phenotype gives 4+ of c antigen when the genotype is c neg.

  • Author
comment_91397
On 11/14/2024 at 7:13 AM, SbbPerson said:

 

May I ask what was the patient's type and screen result prior to any transfusion? 

 

Patient blood group is A Rh D positive and antibody screen negative 

  • Author
comment_91398
On 11/15/2024 at 2:26 PM, Townsend said:

We would honor the molecular typing and provide E-, c-, and K- red cells for this patient moving forward.  Your serologic typing results are not valid due to recent transfusion, and this isn't an uncommon genotype for a thalassemia patient.  Unfortunately this means that the patient received c pos units (when you gave C-, K- red cells), but that was the best you could do without knowing that information before the first transfusion was ordered at your facility.  We come across this frequently with new/relocated sickle and thalassemia patients.

How do you deal with this situation at your end?

  • Author
comment_91399
On 11/16/2024 at 6:43 AM, Yanxia said:

I just can't understand why the phenotype gives 4+ of c antigen when the genotype is c neg.

I guess patient might have multiple transfusion c+ in home country where they don't perform Rh phenotype.  

comment_91400
1 hour ago, gagpinks said:

Patient blood group is A Rh D positive and antibody screen negative 

Aah okay, I guess you answered your own question. The mixed field C result is perhaps due to the dual population of blood transfused. Some may have been C+ and some C-. c+ is a common antigen, almost 80% of Caucasians have it.  That could explain the strong c 4+.  Most place don't do phenotyping after multiple transfusions because of possible dual rbc population , so yes, Townsend is right, "honor the genotyping and provide E-, c-, and K- red cells for this patient moving forward"(Townsend). 

Edited by SbbPerson

Create an account or sign in to comment

Recently Browsing 0

  • No registered users viewing this page.

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.