All things Rhogam
Mother: A, Rh negative, Du negative
Baby: O, Rh positive
Is the mother a candidate for Rhogam?
Yes, the mother is Rh negative and baby is Rh positive.
DD: Mom: A=0, B=0, D=4+, a1 cells=4+, b cells=4+
Baby: A=4+, B=0, D=4+, DAT=1+
What is the most likely cause of the DAT results?
HDN due to ABO incompatibility, Anti-A,B
The sheet of paper that comes with each lot of antibody panel cells and lists the antigens present is called what?
An Antigram.
When patient cells are tested with their serum this is known as...
The Autocontrol
To avoid false-negative reactions due to failure to add the AHG reagent, all negative IAT results should be verified by adding this.
What is Check Cells?
DD: Mother: B, Rh positive
Baby: 0, Rh negative
Is the mom a candidate for Rhogam?
No, mom is Rh positive.
Mom: A=3+, B=3+, D=0, a1 cells=0, b cells=0
Baby: A=0, B=3+, D=0, DAT=2+
What additional testing needs to be performed?
Identification of antibody responsible for the positive DAT via Elution.
Antibody panel reactions of varying strength (1+, 2+, etc.) are an indicator of what?
Dosing or multiple antibodies.
Group O cells from single donors that have been phenotyped are used for these blood bank reagents.
What are reagent cells used for antibody identification. Screen Cells, panel cells
DD: Hemolysis was observed during the crossmatch procedure. This is how the test should be interpreted.
Unit is incompatible.
Mom: O, Rh Negative, Du Negative
Baby: A, Rh negative, DAT positive
Is the mom a candidate for Rhogam?
No, baby is Rh negative.
This is the most severe form of HDN.
What is Anti-D?
DD: Most clinically significant antibodies are detected at which phase of testing?
AHG or indirect coombs phase
DD: This is an example of a potentiator.
What is Low Ionic Strength Solution?
Patient: A=1+, B=1+, D=4+, a1 cells=4+, b cells=4+
This technique may be used to eliminate the interfering substance.
What is prewarm technique?
Mom: A=0, B=4+, D=0, a1 cells=4+, b cells=0
Baby: unknown
Is mom a candidate for Rhogam?
Yes until the Rh status of the infant is known.
A patient received Rhogam at 26 weeks gestation. A Type & Screen was performed as part of the prenatal work-up at 26 weeks and the mother was A neg with a negative screen. Upon delivery the mother has a positive antibody screen. Antibody ID was performed and indicates that Anti-D is present. What is the most likely cause of this?
Screen results are normal/expected. Antenatal RHIG injection.
After antibody identification is complete, what is the next step in the pretransfusion testing process?
Antigen typing the patient for the corresponding antigen.
Agglutination with all reagents, self and donor RBCs, regardless of the antigens present indicates the presence of what?
Autoantibodies.
An unusual antibody is identified that sensitizes cells at cold temperatures and then hemolyzes cells at 37C. This is diagnostic for this disease state.
What is paroxysmal cold hemoglobinuria?
Mother: O, Rh negative, Du positive
Baby: A Rh positive
Is this mom a candidate for Rhogam?
Yes, mom is weak D positive which can create Anti-D and baby is Rh positive
Mom: A=0, B=0, D=3+, a1 cells=3+, b cells=3+
Baby: A=3+, B=0, D=3+, DAT=1+
Eluate: a1 cells=2+, b cells=1+, SC I=0, SC II=0, SC III=0
Last Wash: a1 cells=0, b cells=0
If the infant was transfused with red cells, which red cells should be chosen?
Type 0 PRBCs, less than 5 days old.
This technique is necessary to identify antibodies responsible for a positive direct coombs test.
What is Elution?
Antibody preparation with specificity for multiple epitopes would describe this type of reagent.
What is polyspecific?
When patient cells are tested for the presence of coating antibodies, these testing phases are not performed.
What is immediate spin and 37C