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D weak transfusion


Amra23

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Hi all.
We have an 11 months old female pacient O Rh(D)negative Ccddeek- on forward group.Reverse group shows no antibodies in B cells and +3 with A1 cells.Controls negative.I performed a weak D test and after IAT faze I got a +3 result with anti-D(monoclonal).So I believe is a O Rh( D)weak type 1,right?
Can we give her red blood cells D positive with no problem?Or we'd be much safer with D negative transfusion?
Thank you.

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No!  Sorry Amra23.

You do probably have a baby with a Weak D Type 1, but you do not necessarily have a baby with a Weak D Type 1.  Depending on what your monoclonal anti-D reagent(s) are designed to detect, you could, for example, have a baby with a Partial D VI, and the very last thing you want to do is give a female patient with such a partial D type, D Positive blood.

Certainly, for the time being, I would cross-match D Negative blood until the D type has been proven (either using a whole lot of different anti-D reagents designed to detect various weak or partial D types, or at a molecular level).  It may well be a Weak D Type 1, and so it could be argued that it is a waste of D Negative blood to give this to her, but, personally, I would be devastated if I gave a baby girl D Positive blood, before I had a definitive D type on her, only for her to make an allo-anti-D, which could have a terrible effect on her ability to produce children herself later in life.

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