October 7, 201410 yr comment_57735 It most certainly is, and is an unjustified use of r'r' red cells. The auto-antibody may well look like an anti-c, but is almost certainly a mimicking antibody that is reacting preferentially with c+ red cells. The actual specificity is probably an antibody within the Rh Blood Group System, but is probably against a high prevalence antigen that is also present on r'r' red cells. Therefore, giving r'r' red cells is a waste of time (and r'r' red cells). The only time that r'r' red cells would be justified would be if the c+ red cells did not result in a rise in Hb and the Hb was at a dangerously low level.
October 7, 201410 yr comment_57741 So do I!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! Hopefully, the Pathologist in Charge of the supplier will talk your Pathologist out of the order.
October 7, 201410 yr comment_57745 If you are in the USA, the mention of money can sometimes bring doctors off the ledge and back into reality. Rare units will be enormously expensive.
October 9, 201410 yr comment_57782 Maybe the pt's cells haven't absorbed to their fullest extent so it hasn't "spilled" into the plasma at this point in time - - - it will come eventually (maybe)! How's that for a hedge? I always give Rh phenotype specific rbcs - these folks seem primed to make abs. Whenever I ignore my rule on this invariably I am dealing with an Rh sensitization the next time I see the pt. Not a scenario you want to get into with an active autoimmune. Listen to Malcolm on this. Whatever you infuse is going to be treated just like the pt's own cells so . . . good luck and enjoy. PS - try setting up tubes using PeG, Incubate at 37C, wash 2x with diluent and make into 0.8% cells (if one drop of cells used, add 2-3 drops diluent to dry button) then spin them in an anti-IgG card. Edited October 9, 201410 yr by David Saikin
Create an account or sign in to comment