Example of Selecting Additional Rule-Out Cells - LabCE.com, Laboratory Continuing Education

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The page below is a sample from the LabCE course Antibody Detection and Identification. Access the complete course and earn ASCLS P.A.C.E.-approved continuing education credits by subscribing online.

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Example of Selecting Additional Rule-Out Cells

You are conducting an antibody identification and suspect your patient has developed anti-Fy^a based on your initial rule-ins and rule-outs. You've completed a 3-cell screen and 10-cell antibody panel using the test tube method but despite this comprehensive testing, anti-E has not yet been ruled out. The next cell you select should meet the following criteria:

Negative for Fy^a (so it will not react with the anti-Fy^a that has been identified in the serum of the patient).
Homozygous for big E (big E-positive and little e-negative, so that it will react most strongly with anti-E if present).

You proceed to select a 6-cell panel with diverse antigen expressions. Within this panel, four cells (3–6) meet the first criterion (Fy^anegative). Of these cells, three (4–6) are big E-positive, and of these, only one cell (4) is homozygous for E (big E positive and little e negative). Therefore, cell 4 would be a suitable rule-out cell in this case.

	Rh-Hr						Kell				Duffy		Kidd		Lewis		MNSs				P	Lutheran		Xg
Donor Cell Number	D	C	c	E	e	C^w	K	k	Kp^a	Js^a	Fy^a	Fy^b	Jk^a	Jk^b	Le^a	Le^b	M	N	S	s	P₁	Lu^a	Lu^b	Xg^a
1	0	+	+	0	+	0	0	+	0	0	+	+	+	+	0	+	+	0	0	+	+	0	+	0
2	+	+	0	0	+	+	0	+	0	0	+	0	+	+	+	0	0	+	0	+	+	0	+	+
3	+	+	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	+	+
5	0	0	+	+	+	0	0	+	0	0	0	+	0	+	0	+	+	+	+	+	+	0	+	0
6	0	0	+	+	+	0	0	+	0	+	0	0	+	0	+	0	+	+	0	+	+	0	+	0