Hi,

 

I was just looking for advice/ clarification on the units which are given to someone exhibiting an auto anti-D. The patient has had recent transfusions and the blood which comes from the reference centre is rhesus positive, least incompatible units. However when we cross-match rhesus neg units for the patient in the laboratory they are compatible. I was just wondering why this was. I looked at the guidelines but I'm not sure they answer this question. I was only briefly made aware of this case yesterday so there may be more to it, but his panel only displays an anti-D. PVP positive. 

 

Thanks 

 

Tricia 

May I ask what is PVP?

I think D neg bloods may be better

Not sure I understand what is going on here.  Did the reference lab say anything about partial D?  In any event, if a patient is making auto-anti-D, why not just give them D negative units?

 

Scott

Sorry PVP, patient versus plasma auto control.

Sounds a bit strange that one of the NHSBT Reference Laboratories would give D Positive blood, if the anti-D was NOT a proven auto?

Hi Malcolm as far as I am aware it is a proven auto anti-D , but units they are providing are least incompatible , yet rhesus neg units are compatible, I will look into it in more detail tomorrow and speak to reference centre, will post an update....

thanks

Safe to assume your pt has a +DAT (PVP+)?  I never liked "least incompatible".  If Rh Negs are compatible I'd go with them.  that's not to say that the autoab will not interact with them but I always like to use compatible if I can.

1 hour ago, David Saikin said:

Safe to assume your pt has a +DAT (PVP+)?  I never liked "least incompatible".  If Rh Negs are compatible I'd go with them.  that's not to say that the autoab will not interact with them but I always like to use compatible if I can.

I'm just tickled they're calling something 'least incompatible' when apparently they actually aren't the least incompatible.  Wondering if we're missing something here.

I also am not a fan of "least incompatible".  Gives a false sense of security and really means nothing.

In this case the patient should get Rh negative.

This "least incompatible" thing seems a bit strange to me, as NHSBT uses the term "suitable for", rather than "least incompatible", when giving blood that is not compatible.

Surely anything is going to be more compatible for the patient than their own cells

13 minutes ago, Auntie-D said:

Surely anything is going to be more compatible for the patient than their own cells

Most warm autos hate everybody, so if this one really does like Rh neg cells, that's a 'keeper' as a fisherman would say!