Consulting the Patient's Physician

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

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Consulting the Patient's Physician

The transfusion was immediately stopped after the clinical staff was alerted to the presence of an unexpected antibody, but not before most of the O negative Red Blood Cells had been transfused.
If the physician had decided to continue transfusing the patient at this stage, the following information should have been communicated:
  • Although all donors appear to be compatible in the post-transfusion crossmatch, they are not.
  • The results are false-negatives. The patient's antibody has been "mopped up" by adsorbing to the incompatible transfused O Rh-negative Red Blood Cells.
  • Given that six donors were positive using the pretransfusion plasma, the antigen is a higher frequency antigen and most donors would likely be antigen-positive and incompatible.
  • The patient's physician should consult the transfusion services medical director before any decision to transfuse is made.
  • Transfusing Red Blood Cells before tests are complete requires a physician to sign an emergency release form in which the physician assumes full responsibility.