The purpose of this poll is to examine how an anti-A,B test result can be used to make decisions, either procedurally or policy. Use of the word 'can' is intended to mean 'is it valid' as opposed to 'may' which means 'is it permissable by regulatory agencies'.

That an O donor unit was typed and labeled correctly.

That an O donor unit was typed and labeled correctly.

I believe the option statement in the poll "Can be used to confirm donor rbc units labeled group O" is synonymous with yours.

Yup. Sorry, I didn't see the actual poll when I posted here.

Having been the supervisor of a Red Cross blood typing laboratory for many years...I must mention that you must be aware that some weak subgroups of A or AB may front type negative with anti-A,B. Sometimes it is best to see the whole picture before making a conclusion.

Having been the supervisor of a Red Cross blood typing laboratory for many years...I must mention that you must be aware that some weak subgroups of A or AB may front type negative with anti-A,B. Sometimes it is best to see the whole picture before making a conclusion.

From a transfusion services perspective, I cannot think of a situation that I would select non-group O rbcs for transfusion to a patient whose blood sample is not agglutinated with anti-A,B, regardless of the ABO reverse grouping test results. Having said that, I do believe that a negative result with anti-A,B is a decision maker that does mandate that group O blood be selected for that patient.

I do agree with your donor center experience, but you certainly would not distribute a donor unit with the test results you described?

From a transfusion services perspective, I cannot think of a situation that I would select non-group O rbcs for transfusion to a patient whose blood sample is not agglutinated with anti-A,B, regardless of the ABO reverse grouping test results. Having said that, I do believe that a negative result with anti-A,B is a decision maker that does mandate that group O blood be selected for that patient.

I do agree with your donor center experience, but you certainly would not distribute a donor unit with the test results you described?

If a donor unit is labeled group O, it most likely is correct and confirmation with anti-A,B only, would save on reagents, and time.

Sorry that I came to late to this topic. You are right, It is for financial reason and time consuming that it was decided to confirm an group O unit using aanti-A,B. As of the weak subgroups of A or AB that front type negative with anti-A,B., it is very true that in this case when you look at the all reaction you will have a discrepancy that will prompt you to a weak or absence antigen in front reaction.

 

Thanks

Sorry that I came to late to this topic. You are right, It is for financial reason and time consuming that it was decided to confirm an group O unit using aanti-A,B. As of the weak subgroups of A or AB that front type negative with anti-A,B., it is very true that in this case when you look at the all reaction you will have a discrepancy that will prompt you to a weak or absence antigen in front reaction.

 

Thanks

 

I think everyone missed the point of this poll.  I use an anti-A,B test result for all the listed choices, not just confirming group O donor rbcs.

None of the above. We only use A1B as a second group confirmation for a newborn where reverse grouping isn't possible. All adult groups, on first presentation, have a reverse group done off a second spin to reduce the possibility of wrong-blood-in-card.

 

In the UK we are fortunate in that we don't have to confirm blood bag groups - thinks for the third time today how fortunate we are

The purpose of this poll is to examine how an anti-A,B test result can be used to make decisions, either procedurally or policy. Use of the word 'can' is intended to mean 'is it valid' as opposed to 'may' which means 'is it permissable by regulatory agencies'.

 

We use A,B for confirming O donor units. Is it really necessary to even carry A,B anit-sera. My MI  for my reagent  states that a pos and neg ctrl is required for QC. Previously I used immucor reagent that did  not require both pos/neg ctrl.

Since we do not have any define use in our SOP would you discontinue the use of A,B anti-sera.

Edited October 23, 201311 yr by ESIZENSKY

Additional testing of the red blood cells with Anti-A,B reagent facilitates the recognition of certain weak subgroups and is sometimes used as further confirmation of the reactions obtained with Anti-A and Anti-B reagents.

 

 

 

 

Check your manufacturer. There are some that Anti-A,B is simply a mixture of Anti-A (without the blue dye added) and the Anti-B (without the yellow dye added).

I worked in a lab where we discovered a weak subgroup of A using Immucor Anti-A,B to retype a unit, I believe it turned out to be an A_x. Typing with Anti-A and Anti-B yielded negative results. The Anti-A,B gave weak reactions but were defintiely visible. This unit was promptly returned to the blood supplier for retyping.

How long ago was that clmergen? Was it when polyclonal reagents were used routinely, or since monoclonals came into being?

I hope I am not insulting you with that question!

Ok, is my memory corrupted or was I really taught way back in the 20th century that we had to use Anti-A,B because it would pick up subgroups of A and/or B?

 

And then when monoclonal antibodies became available (yes, it was that far back!), we didn't need to be concerned about that for routine ABO Grouping anymore? 

 

Assuming that ... we do not use Anti-A,B for our routine testing.  But, we DO use it for ABO Discrepancy workups ... guess I'm still searching for that Ax or Bx patient ...

Ok, is my memory corrupted or was I really taught way back in the 20th century that we had to use Anti-A,B because it would pick up subgroups of A and/or B?

 

And then when monoclonal antibodies became available (yes, it was that far back!), we didn't need to be concerned about that for routine ABO Grouping anymore? 

 

Assuming that ... we do not use Anti-A,B for our routine testing.  But, we DO use it for ABO Discrepancy workups ... guess I'm still searching for that Ax or Bx patient ...

No, you are dead right Joanne, but the anti-A (and anti- in a polyclonal anti-A,B was used because the titre of these in a group O donor. in particular a female group O donor, was much higher (normally) than the anti-B in a group A donor and the anti-A in a group B donor, as was the avidity.

With the advent of monoclonal anti-A and anti-B, this was no longer so.

We also still use some old polyclonal (frozen) anti-A,B when we are doing an ABO work-up, but we also do adsorption and elution tests, using the Lui technique.

 

Ok, is my memory corrupted or was I really taught way back in the 20th century that we had to use Anti-A,B because it would pick up subgroups of A and/or B?

 

And then when monoclonal antibodies became available (yes, it was that far back!), we didn't need to be concerned about that for routine ABO Grouping anymore? 

 

Assuming that ... we do not use Anti-A,B for our routine testing.  But, we DO use it for ABO Discrepancy workups ... guess I'm still searching for that Ax or Bx patient ...

Check your package inserts: your Anti-A,B might just be A and B mixed together with no dye.

FWIW the full group and confirmatory groups (in the UK) now have different clones between them for A and D so depending on which one you use you can eliminate variants (to a degree). It also means that a patient can group as Rh neg on first presentation and Rh pos on their second - as happened to me today...

It was 2009 or 2010. We were using Immucor monoclonals.