Exclusion of anti-E in the presence of anti-c

[SMILLER]

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

[Malcolm Needs ☆]

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.

[SMILLER]

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

[Malcolm Needs ☆]

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.

[Brenda K Hutson]

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

[rebeccarjthomas]

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

[EDibble]

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.

[catchmenow51]

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)

[mollyredone]

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.

[Malcolm Needs ☆]

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!