Consider to following scenario: Staight forward antibody ID on patient is anti K, anti C and anti Jkb. Patient has not been transfused in the past 3 months. Auto control on the patient is 1+ positive. Does the auto control need to be investigated? If so what further testing should be done? Thanks in advance.

Consider to following scenario: Staight forward antibody ID on patient is anti K, anti C and anti Jkb. Patient has not been transfused in the past 3 months. Auto control on the patient is 1+ positive. Does the auto control need to be investigated? If so what further testing should be done? Thanks in advance.

I don't think you can do nothing, in case the patient is developing an auto-immune haemolytic anaemia (remember that transfusion itself canbring on, or exacerbate, an AIHA - Petz and Garratty). There fore, I would do a quick elution and see what you get. If it is one of those three antibodies, or another one with a particular specificity, I wouldn't worry too much, as red cells can last longer than the "average" 120 days +/- 10 days, but if it were a non-specific, I would be a little more worried.

That having been said, of course, if you do all these tests and report them faithfully, then it is down to the doctor to do the actual diagnosis, so you will have done your bit and can forget about it!

I agree with Malcolm on this. I think it completes your investigation. DATs and eluates may shed some light on why your patient is anemic enough to need the pretransfusion testing in the first place. And there are many, many patients who really can't be relied upon to furnish accurate information on their recent and distant transfusion history due to age, illness, anesthesia, lack of attention or communication from caregivers, etc etc.

I agree with Malcolm and Dr.Pepper.

As to the transfused cells, you would see a mix field on E or C antigen typing, or others.

You might also want to take a look at the medications the patient is receiving if you access to that.

Especially if he has been receiving gamma globulin - which might have some blood group antibodies lurking in it.....