Switching from O to type specific red cells in pediatric trauma patients

[gksapp]

We have a caveat in our trauma policy that if a pediatric patient has been transfused with type O red cells, you cannot switch to type specific red cells until a new sample shows that they are compatible. I would like to get rid of it; it is an awkward thing to do in the middle of a trauma, but I recently read somewhere that this is the proper thing to do. However, now that I'm trying to find it again, I can't remember where I saw it.

What do others do, and does anyone know where this reference is?

Jerry Sapp

[Mary]

15th edition of the AABB Technical Manual, pages 419-420.

[gksapp]

Exactly.

Thank you.

[Cliff]

That's why I love this place.

15th edition of the AABB Technical Manual, pages 419-420.

[Yanxia]

A little off the subject， I just wonder if a subgroup patient be gaven the normal type blood , will it have hemolysis？ As we know almost all the antibody of ABO subgroup is cold reactive。

We give pediatric patient the same type blood as themselves though the reverse test is weak (serum antibody ).

I have sought for some paper about the subgroup antibody's clinical significance, but I failed.

[galvania]

Dear Shily

I think you would have to be very careful before deciding that a paediatric sample was a subgroup. You know that the A and B antigens are weakly developed at birth, so often look weaker. Also, the A and B antibodies don't really fully develop before the baby is about 6 months' old, so it's quite possible that they are weak or even absent in paediatric samples. And you certainly wouldn't get an anti-A1 (as opposed to anti-A) in a paediatric sample. So no worries.

Anna

[Mary]

Me too.

[Yanxia]

Thanks!

I always trouble myself with the ABO subgroup antibody's significance. I have not saw any HDFN induced by it and any hemolysis by it. Just as you two said it is better to be careful, and I agree with you in the transfusion selection. But the existent will not always be the right , I need an evidence. Sorry for my stubborn.