Jump to content

Incompatible cross match


gagpinks

Recommended Posts

Hi

Patient blood group is A Rh D positive and antibody screen negative. Set up 4 units of A Pos unit and found to be incompatible. Then we set up 3 A Rh D negative units and found to be incompatible.  Therefore panel was set up and found to negative in all cell line.  We set-up 4 unit O Rh D negative and found to be COMPATIBLE.  However DAT is positive in IgG 2+. But why was cross match was incompatible in A red cell but COMPATIBLE with O red cell. 

Link to comment
Share on other sites

Might be a rare IgG anti-A1 - you may not see in in the Reverse (presumably IS or buffer-only gel card), but is detected when you do anything with an antiglogulin reagent. You could try doing the Reverse by IAT. The DAT may just be a red herring, but it might represent a weird autoantibody that favors group A cells.

Edited by exlimey
typo
Link to comment
Share on other sites

The patient's DAT is positive, right?  Has the patient received ABO incompatible platelets lately?  Or received Immunoglobulin therapy (gamma globulins)?  I have seen both of those scenarios cause incompatibilities with the patient's own type.  Could be either Anti-A or Anti-A,B from O platelets or the gamma globulin therapy.  

Link to comment
Share on other sites

9 hours ago, BldBnker said:

The patient's DAT is positive, right?  Has the patient received ABO incompatible platelets lately?  Or received Immunoglobulin therapy (gamma globulins)?  I have seen both of those scenarios cause incompatibilities with the patient's own type.  Could be either Anti-A or Anti-A,B from O platelets or the gamma globulin therapy.  

Good thinking. Might be interesting to see if there's anything in an eluate....

Link to comment
Share on other sites

1 hour ago, cheru26 said:

Have you looked into the possibility of patient having  low incident antibody?   Low incident antibody are  usually picked up during crossmatch.

 

This doesn't fit the pattern for an antibody to a low incidence antigen - in this case, all 7 group A units are incompatible and the 4 group O units are compatible.

Link to comment
Share on other sites

On 3/21/2018 at 7:08 AM, gagpinks said:

Hi

Patient blood group is A Rh D positive and antibody screen negative. Set up 4 units of A Pos unit and found to be incompatible. Then we set up 3 A Rh D negative units and found to be incompatible.  Therefore panel was set up and found to negative in all cell line.  We set-up 4 unit O Rh D negative and found to be COMPATIBLE.  However DAT is positive in IgG 2+. But why was cross match was incompatible in A red cell but COMPATIBLE with O red cell. 

On another track......why the switch to Rh-negative units ?

Link to comment
Share on other sites

9 minutes ago, gagpinks said:

We did 4 A Rh D negative and they all were compatible.  Waiting for eluate result.  Patient had 1 B neg platelet. 

That conflicts with you original post: "Set up 4 units of A Pos unit and found to be incompatible. Then we set up 3 A Rh D negative units and found to be incompatible."

I'm confused.

Link to comment
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now
  • Advertisement

×
×
  • Create New...

Important Information

We have placed cookies on your device to help make this website better. You can adjust your cookie settings, otherwise we'll assume you're okay to continue.