dcross

Patients who produce antibodies to one low frequency antigen commonly produce antibodies to other low frequency antigens as well. Low frequency antibodies are very commonly found in conjunction with anti-E and anti-S (can't tell you why). In our reference lab, we have one patient with 27 low frequency antibodies so this report does not seem outside the realms of possibility. David

We use 5% albumin in lieu of a manufacturers control. While it is true that most manufacturers say a control is not required for monclonal reagents, if you read the fine print of the package insert, you will probably find a statement like "if a positive DAT is suspected, an albumin control is recommended".

In Australia, we phenotype donors on two separate donations before considering the phenotype confirmed. We follow the Code of Europe but, I have checked, and this requirement is not form the Code of Europe (12th ed). I am not sure where we derived this practice from but I believe it to be necessary as mistakes in phenotyping do happen. David

We have had a few patients of late which react quite strongly with our frozen/thawed panel (glycerol 40% frozen at -30C for up to 6 months) but react weakly or not at all with commercial panels. The antibody or antibodies defy identification. We have had at times antibodies (especially Lewis) which react only weakly with our frozen panel but strongly with commercial panels. Not usually the reverse. Has anyone had a similar experience or can suggest an explanation. David

Sorry, you misunderstood me. I didn't mean to tell donors (or patients) that they were D weak. Rather, if the D is not tested by IAT (i.e. Du test), maybe for D negative patients should have a statement like "Weak D antigen has not been excluded" on their reports. Your explanation to the donors is very good though. DC

As I work for a transfusion service and we only test donors, we call the weakest Ds (including Del) D positive. We often get indignant calls from donors insisting that they are D negative. I completely understand the thinking in omitting the Du test in the hospital but maybe the report should refelect the fact that the patient was not etsted for Weak D so that at least it makes more sense when you are trying to explain the discrepancy to them.

Are you sure it wasn't anti-Ahel (Helix pomatia lectin specific for A2 subtype) that was discussed? I know this reagent is sold by Immucor in Europe. I don't believe there is any reagent specific for Ael as, by definition, this subtype is only detectabe by adsorption/elution.

In Australia, it is a requirement to test donors with an anti-D which detects the D VI variant.To my knowledge, the only monoclonal anti-D which detects the DVI variant is the Diagast. In Australia, we follow the uropean standard but I would be surprised if the FDA standard is any different in this regard