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comment_64693

When we encounter with this Rh blood group how to report it and what is you advise for kind of Rh if the patients need blood transfusion?

Edited by mrkeramati

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  • Malcolm Needs
    Malcolm Needs

    I haven't contributed to this thread, for the simple reason that I have no idea how someone (patient or donor) can be weak D positive.  Sadly, in my laboratory, and, I believe, in my country, we do no

  • mollyredone
    mollyredone

    pbaker-Do you weak D type your babies?  We do if the mother is D-, but even if the baby is weak D+, we would report it as D- since we don't want a blood type discrepancy in the future.  On weak D+ bab

  • When they are adults, they will get run on our instrument (NEO) that picks up most weak D reactions, so they stay Rh pos.  If not, we will change their type and put a comment regarding testing methods

comment_64702

pbaker-Do you weak D type your babies?  We do if the mother is D-, but even if the baby is weak D+, we would report it as D- since we don't want a blood type discrepancy in the future.  On weak D+ babies with D- mom, we report that a fetal hemoglobin F should be ordered to confirm a bleed and that the mom is still a candidate for Rhogam.

comment_64704
Quote

We only type babies of group O and/or Rh neg moms.  Yes, weak D typing is required for babies and we call them Rh pos.

 

comment_64707

So do you change their blood type when they are older, since you don't perform weak D on them?

comment_64708

When they are adults, they will get run on our instrument (NEO) that picks up most weak D reactions, so they stay Rh pos.  If not, we will change their type and put a comment regarding testing methods and why the change. 

We have the same type issue when prenatals are done at outside labs that perform weak D (+) and then the moms come here to deliver and we don't (=).  Or a weak D blood donor (+) becomes a patient (=).  We just explain the discrepancy to the physician, call them Rh neg and offer them RhIg, if indicated.

I used to work in a facility that also collected autologous blood.  We were required to weak D donors units, but not patients, so sometimes that got really confusing when their blood type per blood bank is Rh=, but their unit is labeled Rh+.

comment_64754
On 2/26/2016 at 0:29 PM, mollyredone said:

pbaker-Do you weak D type your babies?  We do if the mother is D-, but even if the baby is weak D+, we would report it as D- since we don't want a blood type discrepancy in the future.  On weak D+ babies with D- mom, we report that a fetal hemoglobin F should be ordered to confirm a bleed and that the mom is still a candidate for Rhogam.

We just had a baby come up weak-D pos and I had to decide how to report this.  I chose to go with Rh Neg and add a comment that the weak D was pos so mom needed RhIG.  It was easier to answer the RN's question once than to worry about changing the baby's blood type after dismissal or having questions later in life.

comment_64863
On 2/26/2016 at 8:36 PM, pbaker said:

When they are adults, they will get run on our instrument (NEO) that picks up most weak D reactions, so they stay Rh pos. 

And what if they are partial and should actually be classed as rh neg?

comment_64864

I haven't contributed to this thread, for the simple reason that I have no idea how someone (patient or donor) can be weak D positive.  Sadly, in my laboratory, and, I believe, in my country, we do not have any anti-weak-D.

comment_64865
19 minutes ago, Malcolm Needs said:

I haven't contributed to this thread, for the simple reason that I have no idea how someone (patient or donor) can be weak D positive.  Sadly, in my laboratory, and, I believe, in my country, we do not have any anti-weak-D.

If the Weak D test is positive on a newborn, we report the patient to be Rh Positive, if the Weak D test is negative, we report the patient to be Rh Positive.

comment_64866
2 minutes ago, Dansket said:

If the Weak D test is positive on a newborn, we report the patient to be Rh Positive, if the Weak D test is negative, we report the patient to be Rh Positive.

Ah, that's different - but some people are calling the patient "Weak D Positive" or "Weak D Negative" and, as I said, there is NO such thing as Anti-Weak-D.

comment_64868
36 minutes ago, Dansket said:

If the Weak D test is positive on a newborn, we report the patient to be Rh Positive, if the Weak D test is negative, we report the patient to be Rh Positive.

Am I missing something?  "....if the Weak D test is negative, we report the patient to be Rh Positive."  Just checking.

I agree with Malcolm:  A patient is either Rh Positive or Rh Negative.  If you want to report it as Rh Positive at the weak D phase of testing, well...Ok, but the patient is still just Rh Positive.

comment_64869
26 minutes ago, StevenB said:

Am I missing something?  "....if the Weak D test is negative, we report the patient to be Rh Positive."  Just checking.

I agree with Malcolm:  A patient is either Rh Positive or Rh Negative.  If you want to report it as Rh Positive at the weak D phase of testing, well...Ok, but the patient is still just Rh Positive.

Thank you!

comment_64870
2 hours ago, Dansket said:

If the Weak D test is positive on a newborn, we report the patient to be Rh Positive, if the Weak D test is negative, we report the patient to be Rh Positive.

My bad,  I intended to state, "If the Weak D test is positive on a newborn, we report the patient to be Rh Positive, if the Weak D test is negative, we report the patient to be Rh Negative.

comment_64872

Ok... but are we also talking about when there are weak reactions with anti-D?  Less than a 2+ reaction?  Because, here at our lab, we will send out a female of childbearing potential (less than 45 for us) out for genotyping.  Until those results come back, we treat her as Rh Negative.  Other patients get treated as Rh Positive.

We report out those patients as Rh Negative (override the blood group in the LIS), add a comment, and wait for the genotyping to come back. 

s

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