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Edited June 3, 201510 yr by RollSlow10

If she is 75 and having a baby, I think she has bigger problems than an anti-A1!    Couldn't resist. I am sure you proposed the anti-A1 question hypothetically.

 

Anti-A1 can be naturally occurring so does not require pregnancy or transfusion.  Anti-A1 is usually IgM so can't cross the placenta.  Even if it were somehow partly IgG, I have never heard of it causing HDFN.  I once saw an auto anti-A1.

 

You needed to resolve the ABO discrepancy. I would hope that the methods used would either be in your procedure or the Technical Manual or some other acceptable reference although we all experiment with these odd samples when we get them.  What you did appears to have worked.  You ran appropriate controls to make sure you weren't picking up some other cold agglutinin etc.

 

Missing a very weak A subgroup in a recipient is interesting but it isn't terribly important.  You would give O blood and the patient would be safe.  If such a patient makes a fairly strong anti-A1 we might never suspect a weak subgroup because we would have no ABO discrepancy. (I realize the patient could also have the B antigen, and you would give B blood rather than O etc.)

You need to check what is wrong with this patient.  Leukaemia could well depress her A antigens.    And in this case, I would give group O - whether there was an anti-A1 or not

If she is 75 and having a baby, I think she has bigger problems than an anti-A1!    Couldn't resist. I am sure you proposed the anti-A1 question hypothetically.

 

Anti-A1 can be naturally occurring so does not require pregnancy or transfusion.  Anti-A1 is usually IgM so can't cross the placenta.  Even if it were somehow partly IgG, I have never heard of it causing HDFN.  I once saw an auto anti-A1.

 

You needed to resolve the ABO discrepancy. I would hope that the methods used would either be in your procedure or the Technical Manual or some other acceptable reference although we all experiment with these odd samples when we get them.  What you did appears to have worked.  You ran appropriate controls to make sure you weren't picking up some other cold agglutinin etc.

 

Missing a very weak A subgroup in a recipient is interesting but it isn't terribly important.  You would give O blood and the patient would be safe.  If such a patient makes a fairly strong anti-A1 we might never suspect a weak subgroup because we would have no ABO discrepancy. (I realize the patient could also have the B antigen, and you would give B blood rather than O etc.)

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Edited June 3, 201510 yr by RollSlow10

 If I did not pick up the Anti A1 would she have had a transfusion reaction if administered A1 pos cells?

 

With those results in the forward group, there is no way  (I hope) that ANYONE would have given her A1 cells - or even A2.

 If I did not pick up the Anti A1 would she have had a transfusion reaction if administered A1 pos cells?

 

With those results in the forward group, there is no way  (I hope) that ANYONE would have given her A1 cells - or even A2.

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Edited June 3, 201510 yr by RollSlow10