For routine ABORH, is it a must to run against O cells ?

[keepwalking]

When you do ABORH

For the reverse grouping,

do you run against O cells ?

if no, why not ? don't you have to take care of the bombay group?

Thank you

[Malcolm Needs ☆]

When you do ABORH

For the reverse grouping,

do you run against O cells ?

if no, why not ? don't you have to take care of the bombay group?

Thank you

I wouldn't bother. You will detect the anti-H of an Oh individual in your antibody screen quickly enough.

However, if you run group O cells all the time, you will detect all sorts of "cold" reacting antibodies that you don't want to detect (notably anti-H, anti-HI, anti-Hi, anti-P1, cold anti-M, etc), and then you will have to identify them.

Make your life as easy as possible. Oh individuals are extremely rare, whilst people with "cold" antibodies are extremely common.

Edited March 7, 2011 by Malcolm Needs

[David Saikin]

Have never routinely used group O cells in the back type.

[Bill]

Have never run routine back type against O cells--for reasons that Malcom states.

[Mabel Adams]

Even if you ran O cells and they were positive, you would probably assume you had a cold Ab rather than a Bombay even if it was a real one. It dawned on me a few years back that a Bombay patient would look like a really strong cold agglutinin except the auto control/DAT would be neg. They don't come labeled "Bombay" like the books describe them. Of course, I've yet to see one.

[keepwalking]

I wouldn't bother. You will detect the anti-H of an Oh individual in your antibody screen quickly enough.

However, if you run group O cells all the time, you will detect all sorts of "cold" reacting antibodies that you don't want to detect (notably anti-H, anti-HI, anti-Hi, anti-P1, cold anti-M, etc), and then you will have to identify them.

Make your life as easy as possible. Oh individuals are extremely rare, whilst people with "cold" antibodies are extremely common.

Thank you for all the replies,

What if im only performing ABORH thus no antibody screen to pick up the anti-H

isn't Bombay clinically significant? can we leave them out ?

[Malcolm Needs ☆]

Well, the point is, we would never do a group on a patient for the first time without performing a antibody screen.

Yes, the anti-H of an Oh individual is very clinically significant, but only if they are to have a transfusion, in which case you would, I preseume, perform an antibody screen anyway.

In terms of HDFN, the anti-H is only as clinically significant as an anti-A, anti-B or anti-AB, because the antibody can be mostly IgM, and the H antigen is not fully developed at birth. HDFN due to anti-H is surprising rare amongst a group of very rare individuals.

[keepwalking]

Cos my friend who works in a commercial lab has been performing aborh manually no antibody screen involve and he wants to change to automation. The thing is automation don't provide O cells and that's his concern.

thank you malcom

[keepwalking]

btw, there are labs still practicing on using the O cells for ABORH

what is the reason of running O cells?

[Malcolm Needs ☆]

Well, as I said in an earlier post, apart from detecting an alloanti-H (once in a blue moon), it will detect "cold" reacting allo and autoantibodies, but, hey, who really wants to detect these????????!!!!!!!!!!!!

[Dr. Pepper]

When I first started in BB in the early '70s our commerical back type cells (from Pfizer) were A1, A2, B and O. I think the rationale for the A1 and A2 cells was to detect anti-A1, and the O cells to detect spurious reactions due to cold agglutinins (were those cells always positive for P1, M, N, Lea, Leb???). We switched to just A1 and B as these conditions would still manifest themselves as typing discrepancies or a positive ab screen, or, wouldn't matter clinically (such as a weak subgroup of A with anti-A1 that you mistype as group O but give O blood to). And as Malcolm points out, you avoid a lot of work chasing down insignificant cold agglutinins.

Don't worry about Bombays. You will probably never see one. If you do, it will type like a routine group O but the patient's anti-H will jump out at you from the antibody screen and/or crossmatches. Conceivably you might be requested to give out blood to them in an emergency before screen and XMs are done, but if a Bombay needs blood that urgently, they are out of luck anyway.

[Malcolm Needs ☆]

Conceivably you might be requested to give out blood to them in an emergency before screen and XMs are done, but if a Bombay needs blood that urgently, they are out of luck anyway.

Couldn't have put it better myself!!!!!!!!!!!!!!!!!!

:haha::haha:

[galvania]

While I agree that it's probably a waste of time, unfortunately many countries still require that labs use the O cells routinely (like Switzerland, for example, and I think, but may be out of date, that it's also required in Germany, Austria and Italy). So check with your country's guidelines, if you have any, before dropping it.

As for automation that doesn't have the possibility to test O cells, I find that strange. Which automat are you talking about?

[L106]

My experience mimics that expressed in Dr. Pepper's post exactly.

[DOGLOVER]

In 35 years of Blood Bank have seen 1 Bombay and it was not found by running a group O cell with backtype but found on antibody screen. I sure don't want to know about any cold agglutinins that are hanging around so do not run group O cells when typing.