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comment_75395

Can the autocontrol is positive , negative with cell of antibody screening cells and compatible cross match with RBCs units ?

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  • Bb_in_the_rain
    Bb_in_the_rain

    In addition to the scenario that Yan has describe above, I would like to add awarm autoantibody, where the antibody is saturated on the patient's own cells but has not "spill" into the plasma, therefo

  • If the patient has received transfusion, the transfused antigens pos cells can cause the autocontrol mixed field positive, and when the antibodies are against some low prevalence antigens, then the re

  • Malcolm Needs
    Malcolm Needs

    Most certainly, you need to have a thorough transfusion history on the patient, as my good friend Yanxia says above, but it also depends upon the condition of the patient.  If the patient is exsanguin

comment_75402

If the patient has received transfusion, the transfused antigens pos cells can cause the autocontrol mixed field positive, and when the antibodies are against some low prevalence antigens, then the reaction with screening cells and donor cells can get a neg reaction.

Or some drug induced antibodies can cause this kind of reaction because they are drug dependent.

comment_75448
On 12/15/2018 at 2:46 PM, yan xia said:

If the patient has received transfusion, the transfused antigens pos cells can cause the autocontrol mixed field positive, and when the antibodies are against some low prevalence antigens, then the reaction with screening cells and donor cells can get a neg reaction.

Or some drug induced antibodies can cause this kind of reaction because they are drug dependent.

In addition to the scenario that Yan has describe above, I would like to add awarm autoantibody, where the antibody is saturated on the patient's own cells but has not "spill" into the plasma, therefore DAT and autocontrol may be positive but non-reactive with reagent red cells. 

  • 5 years later...
comment_87675

So in cases where autocontrol is positive and cross-match compatible, can't we give RBC units safely or is there a need for further investigations, if so what do we have to do?

comment_87676

Most certainly, you need to have a thorough transfusion history on the patient, as my good friend Yanxia says above, but it also depends upon the condition of the patient.  If the patient is exsanguinating, the old adage comes into play that it is not a medical triumph to give perfectly compatible blood to a corpse, when, in very many cases these days, a haemolytic transfusion reaction can be treated.  HOWEVER, it is ALWAYS a decision to be made by a medically qualified person, rather than a laboratory qualified person to make, as to how urgent the transfusion may be.

IF there is time, it is always worthwhile doing a few more investigations.  For example, is the patient DAT Positive, and, if so, is it IgG, IgM, IgA (rare), complement or a combination?  Is the reaction seen in the auto-control due to a "cold" auto-antibody, or something else.

To repeat what I wrote above, it MUST always be a decision for a medically qualified person, rather than a "lab rat" (HATE that term, but I hope you know what I mean, without taking offence - being a retired "lab rat" myself), but, if it was a case with which I was dealing, apart from doing a few basic tests (see above) I would be happy to give the blood - and more importantly, receive the blood, if I were the patient.

comment_87700

If the patient has had a recent transfusion, elution studies might show if the antibody coating the cells in the patient's sample has a specificity.

Red cells with the corresponding antigen should be avoided unless you have previously typed the patient and can say whether it's allo or auto.

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