One alternative course of action you can take when all or nearly all of your panel cells are reactive is to adsorb the antibody onto red cells of known phenotypes.
Adsorbing is defined as the process of molecules, ions, or atoms adhering to a surface. In this case, we would be forcing the antibody onto the surface of donor red cells that are previously antigen typed so we could determine which antigens would be adhered to by the antibody and removed from the plasma, aiding in identification.
This is a common technique performed by immunohematology reference laboratories (IRLs) to resolve panreactivity and identify potential underlying clinically significant alloantibodies, however, this process is laborious and time-consuming.
So the question is, is it worth doing in the case of a suspected "HTLA" antibody? The answer is dependent on the identity of the antibody in question, but likely it is not. Adsorbing is a last resort technique used to overcome panreactivity when other techniques are not working. Due to the low avidity of the "HTLA" antibody, it is likely that it will not adhere to the antigens of the red cells well enough to be removed from the plasma. If stronger reactions were observed, adsorbing may be a more optimal choice than performing a titration.
