A 42-year-old male received six units of Red Blood Cells during open heart surgery six months ago. His antibody screen was negative at that time. He has returned for a follow up surgery and his antibody screen is now positive with both screen cells at the AHG phase.
(IS = Immediate Spin; AHG = Antihuman Globulin Phase; CC = Check Cells; AC = Auto Control; NT = Not tested)
| Rh-Hr | Kell | Duffy | Kidd | Lewis | MNSs | P | Lutheran | |
Vial | Donor | D | C | c | E | e | f | V | Cw | K | k | Kpa | Kpb | Jsa | Jsb | Fya | Fyb | Jka | Jkb | Lea | Leb | M | N | S | s | P1 | Lua | Lub | IS | AHG | CC |
I | R1R1 | + | + | 0 | 0 | + | 0 | 0 | 0 | + | + | 0 | 0 | + | + | + | + | + | 0 | + | + | 0 | + | + | + | 0 | + | 0 | 0 | 3+ | NT |
II | R2R2 | + | 0 | + | + | 0 | 0 | 0 | 0 | 0 | + | 0 | + | 0 | + | + | 0 | + | + | + | 0 | + | + | + | + | + | 0 | + | 0 | 2+ | NT |
Refer to Case Study 1 panel below to see reactions of the antibody panel.
| Rh-Hr | Kell | Duffy | Kidd | Lewis | MNSs | P1 | Lutheran | |
Donor Cell Number | D | C | c | E | e | Cw | K | k | Kpa | Kpb | Jsa | Jsb | Fya | Fyb | Jka | Jkb | Lea | Leb | M | N | S | s | P1 | Lua | Lub | IS | 37 | AHG | CC |
1 | + | + | 0 | 0 | + | 0 | 0 | + | 0 | + | 0 | + | + | 0 | + | + | + | 0 | + | + | + | + | + | 0 | + | 0 | 0 | 2+ | NT |
2 | + | + | 0 | 0 | + | + | + | + | 0 | + | 0 | + | + | + | 0 | + | 0 | + | 0 | + | + | + | + | 0 | + | 0 | 0 | 0 | + |
3 | + | 0 | + | + | 0 | 0 | 0 | + | 0 | + | 0 | + | 0 | + | 0 | + | 0 | + | + | 0 | 0 | + | + | 0 | + | 0 | 0 | 0 | + |
4 | + | 0 | + | 0 | + | 0 | 0 | + | 0 | + | 0 | + | 0 | 0 | + | 0 | 0 | + | + | + | + | 0 | + | 0 | + | 0 | 0 | 3+ | NT |
5 | 0 | + | + | 0 | + | 0 | 0 | + | 0 | + | 0 | + | + | + | + | + | + | 0 | 0 | + | 0 | + | 0 | 0 | + | 0 | 0 | 2+ | NT |
6 | 0 | 0 | + | + | + | 0 | + | + | 0 | + | 0 | + | 0 | + | + | + | 0 | + | + | + | + | + | 0 | 0 | + | 0 | 0 | 2+ | NT |
7 | 0 | 0 | + | 0 | + | 0 | 0 | + | 0 | + | 0 | + | + | 0 | 0 | + | + | 0 | + | 0 | 0 | + | + | 0 | + | 0 | 0 | 0 | + |
8 | 0 | 0 | + | 0 | + | 0 | 0 | + | 0 | + | 0 | + | + | + | 0 | + | 0 | + | + | + | + | + | 0 | 0 | + | 0 | 0 | 0 | + |
9 | 0 | 0 | + | 0 | + | 0 | 0 | + | 0 | + | 0 | + | + | + | + | 0 | 0 | + | 0 | + | + | 0 | + | 0 | + | 0 | 0 | 3+ | NT |
10 | + | 0 | + | 0 | + | 0 | + | + | 0 | + | 0 | + | 0 | + | 0 | + | 0 | + | 0 | + | + | 0 | + | 0 | + | 0 | 0 | 0 | + |
AC | | | | | | | | | | | | | | | | | | | | | | | | | | | | 0 | + |
Observations:
- Reactions are occurring at the AHG phase. This indicates an IgG clinically significant antibody.
- Reactions are multiple strengths indicating either multiple antibodies or a single antibody showing dosage.
- The autocontrol is negative which indicates the patient has an alloantibody.