Case Study 2: Transfusion Recommendation

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Case Study 2: Transfusion Recommendation

There is one last step to perform before the laboratory can safely give a transfusion recommendation.
The screen cells are treated with papain and 0.2M DTT and tested with the patient's plasma to rule out or identify any remaining underlying red cell antibodies.
Papain treated cells:
Rh-HrKellDuffyKiddLewisMNSsP1LutheranXg
Cell NumberDCcEeVCwKkKpaKpbJsaJsbFyaFybJkaJkbLeaLebMNSsP1LuaLubXgaAHG
SC I++00+0+0+0+0+0+++0+0++++0++0√
SC II+0++000++0+0+++0++0++0++0+00√
SC III00+0+000+0+0++0+00++0+0+++00√
0.2M DTT treated cells:
Rh-HrKellDuffyKiddLewisMNSsP1LutheranXg
Cell NumberDCcEeVCwKkKpaKpbJsaJsbFyaFybJkaJkbLeaLebMNSsP1LuaLubXgaAHG (PEG)
SC I++00+0+0+0+0+0+++0+0++++0++0√
SC II+0++000++0+0+++0++0++0++0+00√
SC III00+0+000+0+0++0+00++0+0+++00√
Using the combination of the papain treated cells, DTT treated cells, and JMH- cells, underlying antibodies to common red cell antigens have been ruled out. Since the only demonstrating antibody is anti-JMH and it is not typically considered clinically significant, ABO/Rh compatible units that are least incompatible at the AHG phase are recommended for transfusion.