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Using anti-IgG MTS cards for weak D testing


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No, but I think you will find that patients that were 'weak D' in tubes will be Rh pos in the ABD/reverse cards. In a little more than a year we have found at least half a dozen patients that were Rh neg in tube testing that are Rh pos in gel. These were confirmed 'weak D' after the gel cards were Rh pos. ( we routinely do 'weak D' only for childbearing aged women and cord blood.)

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Hi everyone,

Weak D testing on prenatals and Rh negative females of child bearing age is not required. Weak D testing is only required on red cells of donors and infants when determining if mother is RhIG candidate. The current Technical Manual has a nice little explanation about D typing of donors and patients and why D typing on all patients is not required.

JB

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Hi everyone,

Weak D testing on prenatals and Rh negative females of child bearing age is not required. Weak D testing is only required on red cells of donors and infants when determining if mother is RhIG candidate. The current Technical Manual has a nice little explanation about D typing of donors and patients and why D typing on all patients is not required.

JB

You are correct, and that is our policy. However I end up on the phone at least 3 times a week explaining to physicians why we typed the mother as "negative" but when she delivered, the hospital (who still performs Weak D testing) typed her as Rh positive. And they do not understand when I say "both results are correct". :eek:

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Since the D clone in gel is different than the D clones in the tube reagents, you will get variability of reactions. One of the most significant differences is partial D VI, which is negative in gel and immediate spin tube, and positive weak D with Ortho and Immucor tube reagents. Patients with partial D VI could make anti-D if transfused with D positive blood.

At our facilities, when we switched to gel at 3 of our 4 sites, we dropped weak D testing. We found that some patients would test as D negative immediate spin, then D positive in gel the next day for the RhIg workup.

Our solution: We test all immediate spin D negative patients either in gel or IAT. We use the gel result or the negative weak D as our test of record. If the patient tests as weak D positive, or has a history of weak D positive, we test them in gel and use the gel result as our test of record. We never accept weak D positive as a result. The gel D result or weak D negative result goes into their BB record and we do not need to do additional testing once recorded.

For infants, we run tube testing IAT on all gel D negative cords, because we do not want to miss the partial D's. If weak D is positve, then mom is a RhIg candidate, KB stain instead of fetal screen (Yuk). However, the baby would be considered D negative is transfusion was required.

D testing can be a pain, but our protocol seems to work for us.

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