Term
| What do you transfusion to a patient with an ABO discrepancy that urgently needs blood? |
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Definition
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Term
| What is it important to obtain before you transfuse an emergency patient with an ABO discrepancy with O cells? |
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Definition
| sufficient blood for testing |
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Term
| What are the four categories of discrepant results? |
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Definition
| Unexpectedly weak or negative reactions with patient red cells, unexpectedly positive reaction with patient red cells, unexpectedly weak or negative reactions with patient serum/plasma or unexpectedly positive reactions with patients serum/ plasma. |
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Term
| What are some technical errors that could cause ABO discrepancies? |
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Definition
| dirty glassware, improper serum/plasma to cell ration, improper centrifugation, failure to interpret results correctly |
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Term
| What are some problems with cells that could cause ABO discrepancies? |
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Definition
| unwashed cells, transfusion with non-type specific blood, bone marrow transplant, genetic chimerism, coated with ab, weakly expressed ags, improper suspension |
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Term
| What are some problems with plasma/serum that could cause ABO discrepancies? |
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Definition
| high concentrations of proteins, drugs, antibody reactions, unexpected isoagglutinins, antibody against reagent red cells in vitro |
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Term
| What is the initial testing for ABO discrepancies? |
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Definition
| repeat ABO type using washed (4x) cell suspension, plasma/serum, or original reagents |
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Term
| What do you do first if there is an unexpectedly weak or negative reaction with patients cells? |
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Definition
| incubate with auto control for 15 minutes, if the forward and reverse agree, and the auto-control is non reaction then you have an interpretation |
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Term
| an unexpectedly weak or negative reaction with patients cells would be seen in which reaction? |
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Definition
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Term
| What do you do second if there is an unexpectedly weak or negative reaction with patients cells? |
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Definition
| incubate at 4C for 15-30 minutes, auto control must be non-reactive |
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Term
| What do you do third if there is an unexpectedly weak or negative reaction with patients cells? |
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Definition
| repeat the forward reaction with additional anti sera |
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Term
| When do you add Anti-A1 Lectin? |
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Definition
| If you suspect the patient has a weak A subgroup |
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Term
| What do you do fourth if there is an unexpectedly weak or negative reaction with patients cells? |
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Definition
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Term
| What do you do first if there is an unexpectedly positive reaction with patients cells? |
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Definition
| examine reactions microscopically for rouleux |
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Term
| What do you do if rouleux is present? |
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Definition
| perform saline replacement |
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Term
| What do you do after you've performed saline replacement for rouleux and still unexpected positive with patients cells? |
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Definition
| wash cells in warm saline and repeat testing if you suspect a cold antibody |
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Term
| What do you do third if there is an unexpectedly positive reaction with patients cells? |
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Definition
| perform forward type along with control cells with second source of monoclonal antibodies. |
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Term
| What do you do first if there is an unexpectedly weak or negative reaction with patients plasma/serum? |
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Definition
| incubate all tubes at room temperature for 15-30 minutes, spin, read and record, AC and screening cells must be non-reactive |
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Term
| What do you do second if there is an unexpectedly weak or negative reaction with patients cells? |
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Definition
| incubate all tubes at 4C for 15-30 minutes, AC must be non-reactive |
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Term
| What do you do third if there is an unexpectedly weak or negative reaction with patients cells? |
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Definition
| increase the serum/plasma to 4:1 ratio and repeat testing |
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Term
| What do you do first if there is an unexpectedly positive reaction with patients serum/plasma and you know the patient has an anti-p1 or Lewis antibodies? |
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Definition
| treat with substance and then resolve the reserve typing |
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Term
| an unexpectedly weak or negative reaction with patients plasma/serum would be seen in which reaction? |
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Definition
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Term
| What do you do second if there is an unexpectedly positive reaction with patients plasma/serum? |
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Definition
| microscopically observe for rouleux, perform saline replacement if present |
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Term
| What do you do third if there is an unexpectedly positive reaction with patients plasma/serum? |
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Definition
| perform an immediate spin antibody screen and include AC |
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Term
| If the ABSC and the AC are negative? |
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Definition
| Test the patient cells with anti-a1 lectin, if negative then the patient is Asub or AsubB |
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Term
| What do you interpret if the patient had recent incompatible blood components, organ transplant, IVIg? |
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Definition
| probably passively acquired anti-A1 or Anti-B can be made |
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Term
| If one or more of the screen cells are positive and the AC is negative? |
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Definition
| perform a panel at room temp to identify the alloantibody then repeat reverse with donor cells which lack antigen |
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Term
| If all cells of ABSC are positive? |
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Definition
| warm the plasma/serum and reagent cells to 37C, incubate for an hour and perform settled reading (observe for agglutination without centrifugation) |
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Term
| What do you do if Auto Anti-I is suspected? |
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Definition
| perform reserve grouping using O, A1, and B cord cells |
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Term
| Three valid considerations for interpretations? |
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Definition
| (1) forward agrees with reserve (2) expected reactions are >w+ (reserve) and >2+ forward (3) expected agglutination is not from mixed field or rouleux |
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Term
| What to do when valid interpretation cannot be assigned? |
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Definition
| additional samples should be drawn following 6 months in which the patient is transfusion free |
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Term
| What do you give a patient who you can't type? |
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Definition
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Term
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Definition
| Rouleux is a characteristic stacking of red blood cells due to high protein concentrations in the blood |
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Term
| If a patient had rouleux, would the ABO discrepancy be found in the Patient’s Forward or Reverse Type or both |
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Definition
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Term
| 3. When testing an A subgroup patient with Anti-A1 Lectin, would you expect the reaction to be positive or negative? |
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Definition
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Term
| What are the three incubation temperatures used in resolving unexpected weak or negative reactions with patient serum/plasma? |
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Definition
| room temp 15-30 minutes, 4C for 15-30 minutes or lower and longer |
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