Cord Blood Antibody Screens

[ejani]

Our facility has been working on building a Level II NICU. A few days ago, our Neonatologist asked our Blood Bank to perform an Antibody Screen on Cord Blood. I haven't been able to find any literature on this. Does anybody else do this in their facility? or can they give me some feedback? Or maybe willing to share their protocol?

Thanks

[LaraT23]

That sounds odd, because doing a screen on the cord " plasma" is the same as doing a screen on the mother. The physician should know that. Maybe He or She was asking for a DAT and elution and then antibody screen on the elution? Not sure. I don't think you will find any literature on this.

[ejani]

That is what I was thinking as well. We had already done a DAT, which was negative. The baby is an AP and Mom is an OP. The neonate had a bilirubin spike 24 hours after birth and the physician thought it still might be ABO related, even with a negative DAT. So, she wanted an antibody screen on the cord blood to rule out any further possible antibodies. I think she might be confused in the fact that we typically use maternal plasma. The technologist accommodated the physician and did the antibody screen on the cord blood.

Thanks for your response.

[tricore]

I worked at a facility (long ago) where we performed antibody screens on all cord bloods. I never did find out why. The scary part is I had a positive and the antibody was anti-K1 and the person who had performed the type and screen on the mother the previous day had called it negative. Repeated the Mom's and it was positive!

[pdavenport]

I work at a children's hospital with 130 bed NICU. When we're lucky enough to have the cord blood transported with the infant we use it for antibody screen and antibody ID if needed. It facilitates rapid identification of the antibody without having to obtain large amounts of blood from a baby the size of a kitten.

[dcubed]

The only time we would use the cord blood is if it came with a baby transferred to us from another facility. And then only if the antibody screen on a sample from the baby is positive.

[L106]

Many, many moons ago, the facility where I was working tested the cord blood serum against Screening Cells and A and B Reverse Cells when the infant was A or B and the mother was Group O (which is the situation you are describing.) I'm suspect that's what the physician is wanting.

What difference does it make whether there is free-floating Anti-A in the infant's plasma which may or may not cause more cell destruction? Monitor the infant's bilirubin and treat the jaundice! (And if there seems to be a dignificant amount of red cell destruction, monitor the infant's hemoglobin level and treat the anemia if necessary!)

[Deny Morlino]

Monitor the infant's bilirubin and treat the jaundice! (And if there seems to be a dignificant amount of red cell destruction, monitor the infant's hemoglobin level and treat the anemia if necessary!)

Makes waaaaay too much sense, that's why!

[Yanxia]

In ABO HDN , we need to do elution although the DAT is neg.