Routine Du Testing

[klhanks]

I am working with a Transfusion Service that performs a Du on ALL patients that are negative at IS with Immucor Anti D Series 5 or Immuncor MonoBlend reagent and/or any historical Rh negative patient if the history is greater than 5 years.  I have never seen any facitlity follow this criteria.  Is this common?

[Malcolm Needs ☆]

Certainly, when I was working in a hospital, we didn't do this, and we don't now in my reference Laboratory, unless the sample has come in as query Weak/Partial D.

 

If the patient turns out to be a (possible) Weak D, but may be a Partial D, would you not give D- blood anyway, just to be on the safe side (especially females below the average menopausal age, unless they have had a hysterectomy)?

[AMcCord]

If we get results <2+ with Immucor Anti-D Series 4, or Series 5 (on the Echo) or with Monoclonal blend, the patient gets Rh negative blood. If the type is part of a prenatal panel, we recommend RhoGAM to play safe. These are rare individuals, so we are not using up quantities of Rh negative blood with this practice. Some day when molecular testing becomes affordable, we'll probably check them out that way. If their historical record says they are Rh negative, so be it.

 

The only weak D testing we perform is on infants 7 days old or less, partners of Rh negative women with anti-D, and potential organ donor recipients/donors.

[SMILLER]

We have a procedure simular to Mr.McCord, above.  I do not know of many hospitals that chase weak Ds on routine typings.

 

Scott

[Mabel Adams]

Sure, it's common practice to do weak D testing on everyone--if you are a time-traveler back to 1982!    And yup, we called it Du then too.  This was before monoclonal anti-D.  (Trying to be funny here, not insulting.)

 

The only patients we do AHG D typing on are the initially D negative babies of D neg moms and to resolve problems like a positive fetalscreen with a negative Kleihauer or an autologous unit labeled Rh pos when we get a negative D type on the patient.  With modern reagents I have seen too many weakly reactive D patients make anti-D to want to give them D pos blood.  If we aren't going to do that, then why find them?

Edited June 1, 2013 by Mabel Adams

[AMcCord]

"..........  With modern reagents I have seen too many weakly reactive D patients make anti-D to want to give them D pos blood.  If we aren't going to do that, then why find them?"

 

Agree.

[Rh-fan]

No need for any hospital to perform Du testing on patients.

 

Most of then will be negative and when you found a patient that is postive in Du only you need to treat them as D neg. Is a lot of work and costs and any profit.

 

In the Netherlands it is in the guidelines to determine the RhD antigen of a patient with onl one reagent (IgM at RT).

 

Peter

[PAWHITTECAR]

When I took over as superviser here they were still performing weak D testing on every patient, every time they tested.  I found cards on 67 year old men with 20 weak D tests.  One of the first changes I made was to do away with this...well mostly.  My Pathologist still feels that we nees to check women of child bearing age(twice) and of course all babies.