Being unable to rule out an antibody

[DCeDCe]

It doesn't mattrer if the patients antibodies are not showing. That just means that the titer has dropped off to undetectable levels. You should only allocate blood that is e, C, and K negative. DO NOT listen to Whitney poplin!!!! If you give units that are positivevfor those antigens, you can stimulate an immune response, Which will cause a transfusion reaction!!!

[KatarinaN]

This is how we do this (in my lab I don't have to think about ruling out something that might be difficult, such as C under anti-D, we do the phenos):

 

If the patient has a Rh-antibody we do the phenotyping for Rh (ECec + K) and then give blood according to phenotype. And because of electronic crossmatch, this kind of patient with (Rh)antibody will always be serologically crossmatched (not valid for type&screen) and blood units will be selected according to the phenotype, whether the screen is positive or not. 

 

Off course we try to rule out everything we can and luckily we have a lots of cells and panels to use. But sometimes there are situations that someone is hidden behind antibody and then we rely on the phenotype matched blood. Interesting conversation! 

 

(Now going to have a cup of coffee and going to solve one antibody and what to do with it. Last time the titers where so high that our machine was contaminated with the anti-D from the sample.. So manual pipetting it is!) 

[tbostock]

It doesn't mattrer if the patients antibodies are not showing. That just means that the titer has dropped off to undetectable levels. You should only allocate blood that is e, C, and K negative. DO NOT listen to Whitney poplin!!!! If you give units that are positivevfor those antigens, you can stimulate an immune response, Which will cause a transfusion reaction!!!

If you read the original posts, this patient did not have an Anti-C or Anti-K, they just couldn't be ruled out, but later could be ruled out. In that case, it's not necessary to give C and K negative, but again, most of us would continue to give C and K negative, just as a preventative measure.

P.S. This is an open forum where everyone's posts are valued; we gently correct when we disagree, but we want everyone to feel welcome and that this is a safe place to ask questions.

[Auntie-D]

If the patient's antibody screen is currently negative, then that automatically rules out C and K even though they weren't ruled out 5 years ago.  Therefore it is not indicated to give C and K negative units now.  Was the patient transfused at that time (5 years ago?)

 

You can bet the post transfusion sample will be positive if you do this!

 

l believe you are describing an in-vivo crossmatch 

Edited September 14, 2015 by Auntie-D