E-XM with anti-A1

[Mabel Adams]

We are going to the Electonic xm. What do the rest of you do about anti-A1. I know it isn't really considered clinically significant, but with serological xm it sort of took care of itself--A1 units would be incompatible so we would usually do O units. With E-xm if anti-A1 is not put in the computer as clinically significant, I think it would allow A units to be E-crossmatched. Would this be okay or should we make ianti-A1 clinically significant in the computer and require AG xms just for the check for serological compatibility? We could make it a policy to use O units, but the computer wouldn't make sure it happened unless we required full xm.

[bbbirder]

Mabel,

Do you test these at 37? My understanding is that unless they react at 37, you can ignore them and I think the 37 reactive antibodies are pretty rare.

Maybe you could make two different anti-A1 antibodies? Anti-A1 RT and Anti-A1 37, and make one not significant and the other significant?

Linda Frederick

[kelliott]

Hi Mabel, HBB requires that we type the donor RBC's for the A1 antigen if the patient has the antibody attribute. I'm not sure if this is related to how the antibody is defined in our system. If there is no connection to the classification table unfortunately HBB requires that we type O units for the A1 antigen. Fortunately this isn't a common occurrence.

[Lcsmrz]

As with all insignificant antibodies, we ignore them, unless they affect our XM procedure. With Anti-A1, we give Group O RBCs with IS XM.

[Mabel Adams]

Kay, HBB really can't cope with an A2B patient with anti-A1 that needs FFP. It wants the FFP we give to match the patinent's reverse type, which would be just wrong. This guy was a therapeutic apheresis for weeks so we got good at overriding these nutty "factors". Have you run into this problem?