I get confused how do you distingush between high titre low avidty antibodies (HTLV) and just panreactive auto antibodies that react in saline and liss and what is the best way provide blood out of hours for such patients.

Well, the former (the so-called HTLA antibodies) will generally have a negative auto and a negative DAT (although there are exceptions).

The latter will generally have a positive auto and a positive DAT (although, again, there are exceptions).

Neither are clinically significant in terms of transfusion reactions, so you can give blood that is as compatible as self - BUT MAKE SURE THAT THERE IS NOTHING ELSE LURKING UNDERNEATH THAT MAY BE CLINICALLY SIGNIFICANT.

Well, the former (the so-called HTLA antibodies) will generally have a negative auto and a negative DAT (although there are exceptions).

The latter will generally have a positive auto and a positive DAT (although, again, there are exceptions).

Neither are clinically significant in terms of transfusion reactions, so you can give blood that is as compatible as self - BUT MAKE SURE THAT THERE IS NOTHING ELSE LURKING UNDERNEATH THAT MAY BE CLINICALLY SIGNIFICANT.

I agree with Malcolm. And I am very intersting in the exceptions, would you please tell me?

Hi Malcolm, I always like your staright forward, comprehensible replies.

I agree with Malcolm. And I am very intersting in the exceptions, would you please tell me?

Well, we've had a couple of cases where there was an auto-antibody, with a positive DAT, and then, after alloadsorption, we found an anti-Ch underneath (they were fun to try to sort out - NOT), and, of course, there are examples of WAIHA that do not have a positive DAT.

Thank you for your kind comment Liz.

:o:o:o:o

Well, we've had a couple of cases where there was an auto-antibody, with a positive DAT, and then, after alloadsorption, we found an anti-Ch underneath (they were fun to try to sort out - NOT), and, of course, there are examples of WAIHA that do not have a positive DAT.

:o:o:o:o

Thank you,Malcolm.

You say it is alloadsorption, so the anti-Ch maybe autoantobodies which can sensitive the autocells but they can't ben adsorbed by the treated three tube allocells.

Thank you,Malcolm.

You say it is alloadsorption, so the anti-Ch maybe autoantobodies which can sensitive the autocells but they can't ben adsorbed by the treated three tube allocells.

No, the anti-Ch would be an alloantibody, underneath an auto-antibody that had been adsorbed out by the alloadsorption, and which had caused the positive DAT. The cells we use for alloadsorption are treated with papain, which means that they cannot adsorb out an anti-Ch, as the Ch antigen is disrupted by papain.

Malcolm, I understand it, thanks!

My pleasure.