ABO Discrepancy

[JoyG]

When you have an ABO discrepancy due to weakened (<1+) or absent serum/plasma reactivity that was resolved in a previous specimen, how often do you reinvestigate the discrepancy?  For example, each specimen, each admission, or only if it differs from previously observed reactivity?  In this particular instance, Patient currently forwards as a B but reverses as AB however in 2009 patient had similar reactions that were resolved with 15 min room temp incubation.  The employee did not reinvestigate the current results by incubating the reverse because "this was a known history".  What do you think?

[Yanxia]

If the conclusion is  weak reaction  because disease( such as antigen loss or antibodies loss ), low immunity or blood dilution or age youger than 6 month, the next time we will do the investigation again.

Because those factor can change , and if it still extist to influence the result, the ratio is not very high.

[R1R2]

Depends on the type of problem, but at least once per admission.  

[Malcolm Needs ☆]

I agree with R1R2.

[Dr. Pepper]

I agree with the others above; things can change.

[aafrin]

I agree with R1R1; at new admission the problem has to be re-investigated & resolved.

[galvania]

Ok - I am being a bit dumb, maybe - but why? What does it change? If an adult patient was group A with a weak reverse group 2 years ago and he's still group A with a weak reverse group now, whatever the resolution of your reverse group, you're still going to transfuse him with group A, aren't you? (I am assuming that it was properly worked up and you have access to that work-up, and that the patient hasn't had a BM transplant inbetween). So you have an elderly immunosuppressed patient who comes in every 6 weeks for a transfusion - are you really going to do a full work up on the reverse group every 6 weeks? i'm sure you won't because you'll probably only check their ABD without even doing the reverse group half the time...

[John C. Staley]

I'm with Anna, if nothing has changed why bother.  Now if something has changed.....that's an entirely different kettle of fish.

Edited September 24, 2013 by John C. Staley

[Dansket]

I'm with Anna, if nothing has changed why bother.  Now if something has changed.....that's an entirely different kettle of fish. I

I do the same, nothing!

[Abdulhameed Al-Attas]

I completely agree with Anna and John.

Yes, aslong as the previous work is accessable,there is a comment in the system that Alerts  and the patient has NOT had any BM transplant or Massive transfusion of Group O for non Group O patient,Remember there'll be NO change of Blood Group.

So why re-investigate?

Edited September 24, 2013 by Abdulhameed Al-Attas

[JoyG]

Thank you everyone for such a lively discussion.  Much appreciated!

[R1R2]

Again, depending on the discrepancy, it may be very easy to resolve.  I would not repeat any time consuming tests.  I think incubating tubes at RT may be the extent of investigating repeat weak plasma activity.   

[profbaud]

You should be investigating this discrepancy every time you get a new specimen.  Looking back at the previous history can give insight into quickly confirming the problem, but it can't be ignored.  What does your procedure say?  I bet it doesn't say you can skip it if confirmed on previous specimen.  What if that tech made a mistake?

[Mabel Adams]

We would have to resolve it at least minimally to keep our computer happy so that is what we would do.

[Auntie-D]

We only do a reverse group on first presentation, any further reverse groups are irrelevant. Think of the time and money saved...