Posted March 9, 201114 yr comment_34145 a 35 years in labour patients admitted and specimen was send for blood bank for type and screening and the results was:forward grouping was O rh(D)pos using ortho cells reverse was B reaction as 4+ reaction with A1cells (ortho) and negative with B cellsusing autovue automationso the revers cells were repeated using conventional method and incubated for 10-15 min at 4c with AC and ICT and the results were all 4+ as a presence of cold agglutinin what else i can do to tell the blood group?
March 9, 201114 yr comment_34146 You can try 4 drops plasma and immediate spin technique or a room temp incubation with A1, B, O and autocontrol cells.JB
March 10, 201114 yr Author comment_34147 i did add 4drops and read is and incubate at RT but still negative!!!
March 10, 201114 yr comment_34150 Another thing you can do (if the lady is Le(a-b+)) is to get some of her saliva, boil it for a very short while, put it through some form of filter (a bit of tissue paper will do) and see if it will inhibit your ABO antisera, to see if she secretes a and/or B blood group substance (and H come to that, if you happen to have any anti-H to hand).As she is pregnant, it might be worthwhile doing this whatever is her Lewis type, as the Lewis antigen often weakens during pregnancy, due to adsorption by an increased production of plasma lipids, but she will still sectrete the same amount of ABH substance.
March 10, 201114 yr comment_34153 Hi yaya,If the patient urgently requires blood and the antibody screen is negative you could safely give group O. How much additional testing you can do is dependent on what type of reagents you have on hand. Personally, if the patient does not require blood I may not do any further testing and communicate with the patient's physician that she is probably group O and would ask the physician if he would like additional testing to determine blood group.
March 10, 201114 yr Author comment_34158 Thanks for replies it is good that she delivered and did not require blood and i donot think that i can do more investigations
March 11, 201114 yr Author comment_34195 eventually i found that she did bone marrow transplantation !!!!!! thats explain every thing for me
March 11, 201114 yr comment_34199 I hope, in future, that they actually tell you these things before it causes you all this anxt. Honestly, some of these people just make me so angry. It is as if they deliberately keep something back to make life more difficult for the labs.
March 11, 201114 yr comment_34230 eventually i found that she did bone marrow transplantation !!!!!! thats explain every thing for meHow irritating!! (That no one shared this info with you, that is.) You know, in my many years in Blood Banking, I don't think I ever remember a situation where someone called the Blood Bank to notify them that the patient had a bone marrow transplant. Either we "overheard" the info, or we became familiar with the patient or family and knew that was in their plans, or the patient told us, etc. But never has a physician or nurse shared this info (unless we specifically asked them.) I just think that they just don't think!!!I'm glad that your mystery has been solved, yaya.Donna Edited March 11, 201114 yr by L106
March 15, 201114 yr comment_34303 How irritating!! (That no one shared this info with you, that is.) You know, in my many years in Blood Banking, I don't think I ever remember a situation where someone called the Blood Bank to notify them that the patient had a bone marrow transplant. Either we "overheard" the info, or we became familiar with the patient or family and knew that was in their plans, or the patient told us, etc. But never has a physician or nurse shared this info (unless we specifically asked them.) I just think that they just don't think!!!I'm glad that your mystery has been solved, yaya.DonnaI think the problem is that the average physician/surgeon/nurse has no concept whatsoever of what kinds of problems this sort of thing can cause - ABO/Rh discrepancies and not providing irradiated blood products for the patient, are just a start!
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