WAA problems accounted for most of cases we sent to IRL for workup. I am looking for following information and appreciate if you can help:

1). Any vendors can supply “kits” with three cells of R1R1 R2R2 rr? How much? Shelf time? FDA licensed?

2) Any vendor can apply ZZAP “kit”? Cost? Shelf time?

3) This is a wired question: Assuming RH antigen phenotypes of patients availably via monoclonal antisera, is it possible to get commercially prepared (two) reagents which served as allo-adsorption cells with Jka- and Jkb- , respectively? Thanks.

I will imagine these kits, if available, should be exclusive for WAA allogenic adsorptions. Also, does your facility work WAA in house? How you handle it? The more specific, the better. Thanks.

YOu are not going to find kits with R1R1. R2R2 and rr cells except for the screening cell sets. The IRLs usually have units of blood of these Rh types which they also know the phenotype of the major blood group systems for all. This is the main reason that WAA go to IRLs . . . us hospital bbs don't have the luxury of totally phenotyped units for allogeneic absorptions.

I agree with David.

It's beyond the resources of most hospital transfusion services to workup WAA, unless the patient has not been transfused recently.

In that case, you can just do an auto-adsorption using the WARM kit, treat cells with Gamma-Quin so they can be phenotyped, do an elution, then issue phenotype specific blood.

If you want to do allogeneic adsorptions, you have a couple of options. There are no commercial reagents for this test, although there may be blood centers that make stroma and sell it. You can buy enough 3 cell screen kits to allow adsorptions (costly and annoying, but we have done it) or you can see if your blood center will let you have units (or will sell you units) that are appropriately typed. We ask for R1R1, R2R2, and rr units with at least one K negative, one Jka homozygous, one Jkb homozygous, one Fya homozygous, one Fyb homozygous, one S homozygous, and one s homozygous. You can use the cells past expiration. You can even use them past hemolysis as stroma if you wash them well enough (which you need to do anyway). Just make sure you don't wash the stroma away. Remember that some antigens do not age well, so if you are just keeping the cells in the refrigerator you may not get good adsorption after a certain amount of time.