We've had an interesting morning today.

One anti-Inb, one anti-Yta and one (strong) anti-Cob, and it's only a quarter past eleven!!!!!!!!!!!!!

At this rate I am expecting an Oh Rhnull this afternoon!

:crazy::crazy:

Now that's the fun of working in a reference lab! The highlight of my morning was an English muffin and hard boiled egg at breakfast.

I don't usually do benchwork, but the other day one tech was getting bogged down with three positive ab screens and asked if I could grab one to work up. Turned out to be a delayed rxn due to anti-Jkb+Fyb, antibodies you don't see that often by themselves let alone together, with an anti-Goa thrown in to boot. That was fun.

How exciting!

Were the anti-In^b and anti-Yt^a in the same individual, and if so, did you use trypsin to differentiate between the two? We just had an exam and one of the questions was what enzyme to use to differentiate between anti-Yt^a and In^b. The answer was “trypsin” because Yt^a is resistant to trypsin and In^b is sensitive.

Also, did the anti-Yt^a react with almost all cells in the panel since the incidence of Yt^a is about 99%?

Lastly, if the anti-Yt^a and anti-In^b were not in the same individual, was the Yt^a negative patient Jewish or from Israel and was the In^b negative individual from Asian, Iran or an Arabic country?

It’s fun being a student.....

Haven't seen an anti-Goa in years!

How exciting!

Were the anti-In^b and anti-Yt^a in the same individual, and if so, did you use trypsin to differentiate between the two? We just had an exam and one of the questions was what enzyme to use to differentiate between anti-Yt^a and In^b. The answer was “trypsin” because Yt^a is resistant to trypsin and In^b is sensitive.

Also, did the anti-Yt^a react with almost all cells in the panel since the incidence of Yt^a is about 99%?

Lastly, if the anti-Yt^a and anti-In^b were not in the same individual, was the Yt^a negative patient Jewish or from Israel and was the In^b negative individual from Asian, Iran or an Arabic country?

It’s fun being a student.....

Fortunately, no, they were not in the same individual. Trying to find blood to give them that was both In(b-) and Yt(a-) would have been fun (NOT!!!!!!!!!). That was a bit of a cruel question to give you though.

The patient with the anti-Yta is White English.

The patient with the anti-Inb is from India.

It's fun being a Reference Service Manager too!!!!!!!!!!!

:hooray::hooray:

Only one I've ever seen if that's what it was. Sometimes there's an advantage to the old tube testing. Between the anti-Jkb and -Fyb, I had to test every cell we had to find a few negatives to rule in/out. Three cells reacted (in LISS) 1+ after 37o inc. They were all positive in AHG due to the other antibodies. All 3 were Go(a+). Same difference in the end for the patient, though, Fy(b-) Jk(b-) XM compatible.

How exciting!

Were the anti-In^b and anti-Yt^a in the same individual, and if so, did you use trypsin to differentiate between the two? We just had an exam and one of the questions was what enzyme to use to differentiate between anti-Yt^a and In^b. The answer was “trypsin” because Yt^a is resistant to trypsin and In^b is sensitive.

It’s fun being a student.....

And a blood banker as well.......I agree with Malcolm, that was a tough question. May I ask at what level you are a student? I teach the med tech students (going for a BS and ASCP cert) at our school and another, and we don't hold them responsible for much more than the ag/abs on the top of the panel scoresheet. I haven't heard of anyone having problems with the reigstry exam yet. Phil

Yes, it is fun being a blood banker. However, in Phil & Malcolm's cases today, I think it would be even more fun if they didn't want to transfuse the patients (or better yet, it they transferred the patients to other hospitals!)

Donna

I found an anti-Goa with an anti-c in an OB patient last year. First anti-Goa for me. Unfortunately I didn't have the right cells to ID it, just knew there was something odd in the sample. Things like that keep life interesting - in a good way! Unless of course it's a GI bleeder with a 4 Hgb!

Also, did the anti-Yt^a react with almost all cells in the panel since the incidence of Yt^a is about 99%?

Sorry, I didn't answer this bit.

The antibody reacted with all cells in all five of our panels, but by IAT only (not with enzyme-treated red cells - we use papain routinely). That gave us a clue, so we put up a few cell samples of rare negatives that react in that way, and hey presto. We are lucky (nay, very lucky) to have a huge collection of rare cells.

All 3 were Go(a+).

Good Lord Phil. WHere did you find 3 samples of Partial DIV just like that????????????????

Good Lord Phil. WHere did you find 3 samples of Partial DIV just like that????????????????

Sheer good fortune. We get 2 commercial panels, an 11-cell and a 16-cell, and we keep a few old lots for our students. I got one negative cell (Jkb-Fyb-) on my first panel which still left a lot to be eliminated, so I was running every cell I could. While working out the AHG reactions, I noticed the "extra" reactions at 37o and looked at the special antigen typings listed and saw that those cells were Go(a+). Our 2 indated panels just happened to have 3 Go(a+) donors! I looked back through the panel scoresheets and it looks like the company has 4 Partial DIV donors in their stable who donate every 3-6 months or so. I just chanced into a clump of them.

Edited April 19, 201213 yr by Dr. Pepper
clarity and sssspelling

Said it was going to be an interesting afternoon too!

One of my staff members, Alan Gray (a great serologist) came across a new group O R2R2 Kp(a+b-) donor.

Don't get too many days like that!

We had a OB patient with anti-Goa years ago when I was new blood banker. CORD DAT was positive for a baby whose blood type was same as mother. The DAT was weak positive. Performed it 3X, showed microscopic reaction to my supervisor, then my supervisor also repeated DAT which was positive. Mother and baby's specimen sent out and Anti-Goa was id'd. Please do not ask me for nationality becasue I do not remember patient's name. I was very excited!!!!!!!

We had a OB patient with anti-Goa years ago when I was new blood banker. CORD DAT was positive for a baby whose blood type was same as mother. The DAT was weak positive. Performed it 3X, showed microscopic reaction to my supervisor, then my supervisor also repeated DAT which was positive. Mother and baby's specimen sent out and Anti-Goa was id'd. Please do not ask me for nationality becasue I do not remember patient's name. I was very excited!!!!!!!

It sounds as if it was a very weakly positive DAT--did the cells roll off the button roughly and that made you suspicious so that you examined it under the microscope? I would have missed it! I applaud you!

I promise not to ask you for the nationality of the patient, but according to The Blood Group Antigen Facts Book, Go^a is only found in Blacks (2%) and anti-Go^a can cause mild to severe HDFN. Anti-Go^a was first discovered in a Mrs. Gonzales and named after her.

Since Goa is associated with a partial D, should these patients be transfused with RH neg RBCs??

Not necessarily. If the patient has made anti-Goa, then that means that they have been sensitised with a partial D that expresses this "novel" low frequency antigen. They, themselves, may well have a "normal" D antigen.

Thanks Malcolm! We posed the same question to our reference lab and they said the same thing. I just transferred to Childrens Hospital and I am now encountering antibodies that I have never seen before because of the sickle cell patients. It is very different than my old trauma hospital.

Question please: where do you get the partial D VI for QC ?

thank you

Well, personally, we have Partial DVI red cells frozen down in small aliquots for use whenever we need them, but the Go(a) antigen is associated with Partial D Type IVa, rather than Partial D VI (that's the BARC antigen - at least, that's the BARC antigen with the DCe haplotype), but we also have Partial D Type IVa frozen down in small aliquots whenever we need them.

This is NOT down to my prowess, but to one of my staff members (and my friend) Alan Gray, who has been responsible for screening for rare donors for over 25 years.

Thank you and thank you all for this thread.. very interesting.

A reference lab has all the luxuries of a 5 star hotel.

Dr Reids has retired and at the AABB recieved an award.

A reference lab has all the luxuries of a 5 star hotel.

So true Liz, and I love my professional life of luxury!!!!!!!!!!!