A 42-year-old patient, born male, underwent open heart surgery six months ago, during which they received six units of Red Blood Cells. At that time, their antibody screen was negative. They have since returned for a follow-up surgery, and their current antibody screen has tested positive with both screen cells at the AHG phase.
| 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 |
IS = immediate spin; AHG = antihuman globulin; CC = check cells; NT = not tested
Refer to antibody panel reactions below.
| 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 | + |
IS = immediate spin; AHG = antihuman globulin; CC = check cells; NT = not tested; AC = autocontrol
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.