dotahill Posted June 24, 2011 Share Posted June 24, 2011 We are having such a hard time in our lab right now ruling out Anti-C and Anti-E with our 16 cell panel when the antibody is an anti-D. We are still doing tube testing. I was wondering if anyone has run into this and what you are doing to combat this. I am getting sick of sending samples to the ARC for an Anti-D. I am trying to figure out best practice, i.e. bringing in a 12 cell panel in addition to our 16 cell, or bringing in PEG. The panels are starting to be very unhelpful! Link to comment Share on other sites More sharing options...
Malcolm Needs ☆ Posted June 24, 2011 Share Posted June 24, 2011 I don't know this panel whatsoever, but could you not enzyme-treat the r'r (if there is one)? This would rule it out, as Rh antibodies almost always react preferentially with enzyme-treated red cells. If it doesn't react with the r'r, there is little chance that there is an anti-C there as well.If you don't have an r'r in the panel, I'm a bit stuck for an answer. Link to comment Share on other sites More sharing options...
John C. Staley Posted June 25, 2011 Share Posted June 25, 2011 Just a question or two, what is your criteria for ruling out? Who's panel are you using? I do recommend a 16 cell panel. We would run the first 12 and then if necessary the extra 4 would come in handy. Also it gave you 4 more cells to consider when looking for specific cells.I remember panels where I could not rule out anti-Fya if the patient had an anti-E (Dade was infamous for that) but I don't remember having any problems ruling out either anti-C or E when an anti-D was present.:juggle: Link to comment Share on other sites More sharing options...
David Saikin Posted June 27, 2011 Share Posted June 27, 2011 We can r/o Anti-C or anti-E with enzyme pretreated r'r or r"r . . . just like Malcolm says. Link to comment Share on other sites More sharing options...
clmergen Posted June 27, 2011 Share Posted June 27, 2011 Article from the 2008 IRL conference hosted by ARC (when they still did those). It has a suggested protocol for ruling out anti-C or anti-E in the presences of anti-D. http://a1881.g.akamai.net/7/1881/26640/v0001/redcross.download.akamai.com/26640/pubs/immuno/24_2_08.pdf Link to comment Share on other sites More sharing options...
Mabel Adams Posted June 29, 2011 Share Posted June 29, 2011 We don't have enough use for it to keep enzyme. I allow rule out of anti-E & C in the presence of anti-D with a single heterozygous cell for each because the odds that I will give a unit that is pos for either is less than that I will give a Co b pos unit in an electronic xm to someone with an undetected anti-Co b. We don't worry much about that, do we? All but a couple of percent of D neg units will be C neg and E neg. Even if we missed one, we would be very unlikely to give more than one unit that is pos for either C or E to the same patient in the same testing episode. If the antibody is too weak to be detected with a hetero cell (especially with a sensitive technique like PEG or gel) it probably won't cause any noticeable transfusion reaction. Remember, we rule out anti-K with a single heterozygous cell on every negative antibody screen we do. clmergen 1 Link to comment Share on other sites More sharing options...
John C. Staley Posted June 29, 2011 Share Posted June 29, 2011 Thanks Mable, I was waiting to see if someone else would cover this. Your explanation covered, exactly, the system we worked under which was why I was surprised some one was having trouble ruling out anti-C and anti-E when anti-D was present. That's why, in my initial response I inquired as the the rule out criteria being utilized. Link to comment Share on other sites More sharing options...
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