Transfuse what?

[ABADI]

hi ... we had a patient ( AB Pos) , he received 2 units of cord blood as ( O Pos & O Neg)....in this case which blood type shall we transfused for him ????????

[Mabel Adams]

Is this a bone marrow transplant using 2 units of cord blood as the source of bone marrow stem cells? If so, the patient's original immune system will not make any ABO antibodies and his new immune system, as it gets established, could eventually make both anti-A and Anti-B. He has tissue cells that will still express the AB antigens. I believe this sometimes absorbs out the antibodies made by the graft so he may not make much in the way of ABO antibodies. Still, I can't see where you could go wrong by transfusing O red cells and AB plasma.

Platelets would be harder. It is customary to make sure the product is plasma compatible with the patient red cells before worrying about the ABO of the plts themselves, but you may have a hard time getting AB plts and will have to give whatever you have.

Someone else can feel free to clarify if I have not got this right. I just can't stand an unanswered post for too long.

[Yanxia]

I think the cord blood will not produce any antibodies againse A and B antigen . The reason is that they are immature and the AB antigen of the patient will present an immuno-suppression to it.

How to transfuse? I think we can obey the rule of bone marrow transplant or PBSCT.

[ABADI]

Thanks alot about this one ....

[TStec]

When we transplanted multiple cord bloods, we found that the donor cells from one cord re-populated the recipient's marrow. We observed the blood type become mixed in our testing, going from an A Neg to du positive, to a AB and then to B Pos. I think we transfused O Neg red cells. The recipient was chimera in HLA for awhile. Eventually when they relapsed, we saw the original HLA/ RBC type return. It was a very interesting case to follow.