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Lutheran A question


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Just wondering what other places do...... we have a patient with a previously reacting Lua. It is no longer detectable, but now she has built a Kpa. We are screening units for the Kpa and doing coombs crossmatches but there is a question whether we still need to screen these units for the Lua antigen as well. In The Blood Group Antigen Facts Book it states that Lua is not implicated in transfusion reactions or HDN. :confused:

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Just wondering what other places do...... we have a patient with a previously reacting Lua. It is no longer detectable, but now she has built a Kpa. We are screening units for the Kpa and doing coombs crossmatches but there is a question whether we still need to screen these units for the Lua antigen as well. In The Blood Group Antigen Facts Book it states that Lua is not implicated in transfusion reactions or HDN. :confused:

We wouldn't dream of recommending that Lu(a-) blood be given over this siode of the pond. It does not cause haemolytic transfusion reactions, and, for various reasons (such as the fact that the Lutheran antigens are not well developed at birth, the antibodies are often IgM and, even if they are IgG, are probably adsorbed onto the apical side of the placenta) do not cause haemolytic disease of the newborn. We would always recommend blood compatible by the indirect antiglobulin technique.

We very rarely recommend that Kp(a-) blood be given. The instances of haemolytic transfusion reactions caused by anti-Kpa have always involved an antibody with a fairly meaty titre, and so a unit that is found to be compatible by the indirect antiglobulin technique are unlikely to cause a clinically significant reaction, although, of course, they may boost the antibody.

:)

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any antibody found in course of transfusion history of a pt wheather it is visible next time or not the safest is to give blood negative for the one....as the antigens positive for the same anti body will prove to be a booster dose ...........which will create a delayed transfusion reaction in the pt

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any antibody found in course of transfusion history of a pt wheather it is visible next time or not the safest is to give blood negative for the one....as the antigens positive for the same anti body will prove to be a booster dose ...........which will create a delayed transfusion reaction in the pt

I would challenge you to produce ANY reputable paper that suggests that anti-Lua is a clinically significant antibody.

The same goes for an awful lot of other antibody specificities.

I would suggest you read The Blood Group Antigen FactsBook by Marion Reid and Christine Lomas-Francis before making such sweeping statements.

:(

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Mainwaring and pickles 1948 attempted to assess the immmunizing capacity of Lua antigen using Lu(a+) blood for transfusion to eight Lu(a-) pts, after a single transfusion two out of eight deveoped anti-l

Lua of agglutinating type.....................................................from the experiments of Mainwaring and pickles it might appear that anti Lua is formed quite readily by Lu(a-) subjects recieving more than one transfusion of Lu(a+) blood ..........................pls read mollison 8th editon ch 9

we as blood bankers have to bother if we can provide compatible blood if a pt is recieving blood at regular intervals like sickler ,thallasinic etc....to us transfused cells are regarded as incompatible if their survival is curtailed by anti bodies

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Mainwaring and pickles 1948 attempted to assess the immmunizing capacity of Lua antigen using Lu(a+) blood for transfusion to eight Lu(a-) pts, after a single transfusion two out of eight deveoped anti-l

Lua of agglutinating type.....................................................from the experiments of Mainwaring and pickles it might appear that anti Lua is formed quite readily by Lu(a-) subjects recieving more than one transfusion of Lu(a+) blood ..........................pls read mollison 8th editon ch 9

we as blood bankers have to bother if we can provide compatible blood if a pt is recieving blood at regular intervals like sickler ,thallasinic etc....to us transfused cells are regarded as incompatible if their survival is curtailed by anti bodies

I am afraid, irshadaad, that you are confusing immunogenicity of the antigen with clinical significance of the antibody, but even the results of Mainwaring and Oickles are at odds with those of Greenwalt and Sasaki, and \\\\\\\\\\those quoted by Race and Sanger. The fact that an antigen can readily stimulate an antibody does not mean that the antibody that has been stimulated is clinically significant.

I would advise you to read chapter 6, pages 224 and 225 of Mollison's Blood Transfusion in Clinical Medicine (editors Harvey G. Klein and David J. Anstee), 11th edition, where the antigenicity of the Lu(a) antigen is discussed in one section and the clinical significance in another.

As far as clinical significance of anti-Lua is concerned, I would also urge you to read page 279 of Human Blood Groups by Geoff Daniels , 2nd edition, pages 674 to 675 of Applied Blood Group Serology by Peter D. Issitt and David J. Anstee, 4th edition, and page 198 of The Blood Group Antigen FactsBook by Marion E. Reid and Christine Lomas-Francis, 2nd edition, all of whom are far better serologists and far more knowledgable than I will ever be.

:mad:

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