Type Discrepancy

[dpapp820]

We worked up a type discrepancy for a serivce hospital that forwards as an A and came up w+ on reverse A1 and A2. It turned out to be rouleaux and was resolved with saline replacement. As part of the type, we ran an Rh that was 2+ and the control was negative. We reported A pos.

2 days later the hospital reported they had a historical A neg for the patient (which was never shared with us at any point previously). Of couse, now none of the original results can be duplicated including the rouleaux.

Has anyone seen plasma proteins interfering with the Rh like this? Any suggestions on how to approach in the future, aside from making the hospital provide ALL relevent information?

[Mary]

Our refernce lab requires that we complete a form with all of the info we know on our patients that we refer to them. If it is not filled out correctly they call us and "review the instructions" for filling it out!

It's only fair to give them all they need.

[rcurrie]

Different reagents, different methods, different results. Your Rh pos is correct if you followed your procedures. Their Rh negative is still Rh negative if they followed their procedures. It isn't always clear cut. I personally think anything less than 3+ on Rh should be called Rh negative for transfusion purposes.

We have a donor whose results alternate between positive and negative by PK method. We just have to reconcile the current results with the historical and invalidate the Rh negative results.

BC