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ABO Minor Mismatch Platelets.


richj

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Good Morning,

An AB Positive patient received a unit of A Pos platelets 12/29 evening uneventfully.

The patient then received a unit of AB Positive Rbcs during the night and developed chills and a fever of greater than 1C to 39.3C from 37.8C.

The pre and post transfusion workup was uneventful other than the Pre DAT was negative and the Post DAT was positive (Complement only)

Does this represent the Anti-B in the platelet unit? Should an eluate be done for complement only and what is the blood and platelets of choice for this patient going forward.

Note the patients HGB has dropped to 54 form 76 ..However there are no signs of hemolysis.

Thoughts greatly appreciated..

Thanks,

Richard

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The patient is AB, I don't think the transfused Rbcs are the problem. Maybe because the A platelets with high titer of anti-B or the patient's blood volume is smaller than normal adult.

I think do an elution is good to prove what is on the red cells, there are lots of ABO HDFN has neg DAT, but pos elution.

 

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The patient is AB, I don't think the transfused Rbcs are the problem. Maybe because the A platelets with high titer of anti-B or the patient's blood volume is smaller than normal adult.

I think do an elution is good to prove what is on the red cells, there are lots of ABO HDFN has neg DAT, but pos elution.

 

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Are there any other reasons for the drop in hemoglobin?  It would not hurt to perform an eluate and be sure to include running some B cells with the eluate.  If you have any remainder of the A pheresis, you may want to perform an anti B titer too.   

 

Keep us posted. 

 

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