John C. Staley Posted May 2, 2005 Share Posted May 2, 2005 The patient is type B pos, a couple weeks ago they had a positive DAT and antibody screen. The antibody identified was an auto anti-e. Today the antibody screen and the DAT are both negative. Question: Do you continue to provide R2R2 cells? Link to comment Share on other sites More sharing options...
John C. Staley Posted May 3, 2005 Author Share Posted May 3, 2005 Additional info: Between the positive and negative test results the patient received only 3 RBC units and 1 apheresis plt. Link to comment Share on other sites More sharing options...
Dawn Posted May 4, 2005 Share Posted May 4, 2005 We usually honor warm autoantibodies with anti-e or any other specificity while they are demonstrating. If they disappear or become reactive with all cells then we no longer give antigen negative. We had one patient who had auto anti-e and allo anti-E. That was a tough one. We gave her E neg for a while then her auto anti-e became hemolytic so we switched to e neg. The transfusion recommendation flip-flopped for many weeks. Link to comment Share on other sites More sharing options...
Shannon Posted May 4, 2005 Share Posted May 4, 2005 We honor warm-autos with specificity only when they are demonstrating. We had a similar problem as Dawn with an Rh neg. patient that had a warm auto anti-e. Link to comment Share on other sites More sharing options...
janet Posted May 5, 2005 Share Posted May 5, 2005 What about the literature that supports giving phenotypically matched.....does anyone else agree with this philosophy? Link to comment Share on other sites More sharing options...
Cliff Posted May 5, 2005 Share Posted May 5, 2005 Good point, but what about the dilemma Dawn mentioned above? What do you do when they start hemolyzing?What about the literature that supports giving phenotypically matched.....does anyone else agree with this philosophy? Link to comment Share on other sites More sharing options...
janet Posted May 15, 2005 Share Posted May 15, 2005 By Cliff's reply I would assume that if you think the patient is hemolyzing (I guess you would know if hgb did not rise, icterus, etc???) the phenotypically matched units the lab should forget trying to avoid making allo-antibodies and give units that won't "feed the fire" anymore?? I have read much literature supporting phenotypically matched units in auto-antibody cases but I guess this kind of goes against all we try to do when we identify an antibody (give antigen negative units).Without the ability to do auto-absorbtions after transfusing how could you know you won't make matters worse causing the patient to make allo-antibodies?How would you know which route to go??? Look for those signs of hemolysis then go for the antigen negative units? Link to comment Share on other sites More sharing options...
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