LOL! And then all potential recipients are screened for the Rh's and K, and given the appropriate antigen negative units to avoid sensitation?  (as some here say they do for E antigen for patients that show only anti-c, but are antigen negative for E and c?)

 

Scott

Yes, but only really for females of "child-bearing potential" (horrible phrase - makes them sound like farm animals) and for those who are transfusion dependent.

Well, we are especially careful with those over here also.  Then there's endless-txn patients like those living with sickle-cell anemia.

 

Someday someone is going to figure out how to make decent artificial blood, and this will all be academic!

 

Scott

Prof Dave Anstee is well on the way to growing red cells from CD34+ cells.

They have foetal type antigens, such as ii, Ch-, Rg-, weak Lutheran antigens, etc.

He's got as far as about half a universal bottle's worth, but, of course, scaling it all up is the key.

Depends on where you work and what your resources are. It would be "nice" to give R1R1 to a patient with anti-E or anti-c who is negative for the other; or to give R2R2 to a patient with anti-e or anti-C who is negative for the other. But especially with the R2R2 units...you are taking valuable resources from patients with anti-e if your patient just has an anti-C (and some Donor Facilities won't give that up unless you have an anti-e). While it is true they may go on to make the other antibody; it is not a high enough frequency that we have done it most places I have worked.

Brenda Hutson

Ya.

Still... if we wanted to be really careful, we would completely phenotype for every significant antigen for both the patient and donor units. And I think that is where we are headed when we screen for E with anti-c patients, or for e with anti-C patients.

(In general, I think we are already enough anal-retentive!)

Scott

Molecular people would agree with your first statement. rjt

All,

 

What do you report on a CAP survey, when anti-c is identified in a sample that you can't rule-in or rule-out anti-E?

Isn't there always the option to select "other" and fill in the answer, or choose that you would send it out for further testing? Different labs have different resources.

In our reference lab, when a patient demonstrates an anti-c, we phenotype for E. If the patient is E- we recommend giving c and E negative units even if we have ruled out an anti-E. Percentages are very high for the development of an anti-E to ignore the E. We don't do the reverse for anti-e because of the lower antigenicity of C (unless of course it's a patient that will be transfused multiple times)

So you can rule out anti-E with a heterozygous cell in the presence of anti-c, just like you would anti-C and anti-E in the presence of anti-D?  I haven't seen that on any lists, but I would love to be able to use it.

Unless you have an R_zR_z, R_zr_y or r_yr_y cell sample handy, I think you are going to have to mollyredone.

 

Cells aren't heterozygous; genes are heterozygous!