A hospital in our area called today to share a tale about a patient who typed as A Rh pos on the ProVue w/ no plasma /cell discrepancy in ABO gel card, but was an A subgroup (lectin negative) with 2+ anti-A1 in tube testing. The crossmatches with A1 RBCs were compatible on ProVue, but incompatible in tube testing. Has anyone else ever seen this and what kind of clinical complications would be expected if RBCs ( A1 w/ anti A1) are transfused? Also, what are some opinions if the ProVue can't detect weaker forms of plasma /cell discrepancy-really a challenge if only using ProVue and computer crossmatching. An Ortho resource says it has to do with "harder spin in tube centrifuge v softer spin gel centrifuge".

Thanks!

Ortho are probably correct about the centrifugation.

Unless the anti-A1 reacts strictly at 37oC, there would be no clinically significant sequelae if A1 red cells were transfused.