Posted November 1, 20177 yr comment_71364 Hi It might be silly question but can we rule out Anti-K by using Heterozygous line ? I understand KK red cell have more sites (4000-6000) where as Kk red cells have 2500-3500) sites. Also BSH guidelines suggest you need to have one homozygous line to exclude antibody. It is difficult to exclude when patient has more than one antibody.
November 2, 20177 yr comment_71366 In my opinion (and that of the BCSH Guidelines) you do not need a K+k- red cell to rule out anti-K. If you look at the antigen profile of the red cells you use every day as screening cells, they will not have a K+k- cell, and yet you are ruling out the presence of anti-K (and any other antibodies directed against the major blood group antigens) with each sample that gives negative reactions with these red cells. In addition, if you look at the screening cell profile that the BCSH Guidelines recommend, they say that the K antigen MUST be represented, but NOT that these cells must be K+k-.
November 2, 20177 yr comment_71367 I remember from somewhere that Kell doesn't or is least likely to show dosage.
November 2, 20177 yr comment_71368 I have seen about two cases of this in 43 years in blood transfusion. Yes, they exist - but so does Rhnull!!!!!!!!
November 2, 20177 yr comment_71369 I have seen dosage a couple of times and a >K reacting at room temp only. I agree with Malcolm and his reasoning why K+k- cell is not required to rule out >K.
November 2, 20177 yr comment_71370 I agree with Malcolm. In theory, there may be examples of anti-K that only react with K+k- cells, but in practice it's a very rare event. One of my former colleagues/mentors once said that one shouldn't worry about missing a weak antibody. If the patient were unfortunate to be transfused antigen-positive blood, the former weak antibody would be super-strong next time around !!! Problem solved.
November 2, 20177 yr comment_71371 2 hours ago, exlimey said: One of my former colleagues/mentors once said that one shouldn't worry about missing a weak antibody. If the patient were unfortunate to be transfused antigen-positive blood, the former weak antibody would be super-strong next time around !!! Problem solved. I have an idea I may know who that was!
November 2, 20177 yr comment_71372 That is what my former supervisor used to say (he was a tech for over 50 years)! Get the titer up where you can work with it! God rest him!
November 2, 20177 yr comment_71373 7 minutes ago, BldBnker said: Get the titer up where you can work with it! I like that ! None of this wishy-washy, barely reactive stuff.
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