Transcript Donor ABO Blood Grouping Discrepancies

Donor ABO Blood Grouping
Discrepancies
Heather Hume
Greg Denomme
CBS HO Serology Laboratory
Feb 20, 2009
Donor ABO Blood Grouping
Discrepancies
• This part of the presentation shows the initial results
only.
• Look at these results and think about the next steps in
the investigation of the ABO grouping discrepancies.
• Investigations will be discussed on the teleconference.
• Presentation with the investigation will be made available
just before the teleconference.
References
• Westhoff CM, Reid ME. ABO and related antigens and antibodies. In
Blood Banking and Transfusion Medicine Basic Principles and
Practice 2nd ed. Hillyer CD et al eds. Churchill Livingstone,
Philadelphia, PA. 2007: 69-79.
• ABO, Lewis and P groups and Ii antigens. In Mollison's Blood
Transfusion in Clinical Medicine 11th ed. Klein HG, Anstee DJ eds.
Blackwell Publishing Inc, Malden, MA. 2005:114-162.
• Investigating ABO typing problems. In Judd's Methods in
Immunohematology 3rd ed. Judd WJ, Johnson SJ, Storry JR eds.
AABB Press, Bethesda, MA. 2008: 515-558
GAL
GAL
GLNAC
GAL
GAL
GLNAC
GL
GAL
GALNAC
GL
GAL
Group ‘O’ Antigen
GLNAC
GAL
GL
Group ‘A’ Antigen
Group ‘B’ Antigen
Basic ABO Grouping
Forward grouping
Reverse grouping
ABO group
Anti-A
Anti-B
A cells
B cells
neg
neg
pos
pos
O
pos
neg
neg
pos
A
neg
pos
pos
neg
B
pos
pos
neg
neg
AB
ABO Blood Grouping Discrepancies
• Missing reactivity?
– apparent absent antigen
– apparent absent antibody
• Additional reactivity?
– apparent extra antigen
– apparent extra antibody
ABO Blood Grouping Discrepancies
Most Common Causes
• Patients
– decreased antibody levels
• physiologic - newborns, elderly
• immunodeficiency - congenital or acquired
– auto- or alloantibodies
– recent transfusion
– HSCT
• Donors
– unusual blood group - genetic polymorphisms
Donor Testing Laboratory Results
Case #1
PK7200 Data Log Results
Donor #2
ABO
Rh
-B
-A
-A,B
D1
D2
Control
A1
B
???
Pos
-
?
+
+
+
-
-
+
Prediluted Olympus reagents used
DTL Manual Bench Results
Method
I.S.
-B
-A
-A,B
A1
A2
B
O
-
-
2+
-
-
3+
-
-
1+
2+
-
-
3+
-
Donor #2
RT 30’
Immucor Gamma-clone reagents used
Donor Testing Laboratory Results
Case #2
PK7200 Data Log Results
Donor #5
ABO
Rh
-B
-A
-A,B
D1
D2
Control
A1
B
???
Pos
-
-
-
+
+
-
-
+
Prediluted Olympus reagents used
DTL Manual Bench Results
Method
I.S.
-B
-A
-A,B
A1
A2
B
O
-
-
-
-
-
2+
-
-
-
-
2+
-
3+
-
Donor #5
RT 30’
Immucor Gamma-clone reagents used
Donor Testing Laboratory
Results Case #3
PK7200 Data Log Results
Donor #3
ABO
Rh
-B
-A
-A,B
D1
D2
Control
A1
B
???
POS
-
-
+
+
+
-
-
+
Prediluted Olympus reagents used
DTL Manual Bench Results
Method
-B
-A
-A,B
A1
A2
B
O
I.S.
-
-
MF
3+
3+
4+
2+
RT 30’
-
-
MF
3+
3+
4+
4+
Donor #3
Immucor Gamma-clone reagents used
MF=mixed field
Donor Testing Laboratory Results Case #4
Unit returned to CBS - Labelled B pos, tested AB pos at hospital
PK7200 Data Log Results
Donor #4
ABO
Rh
-B
-A
-A,B
D1
D2
Control
A1
B
B
POS
+
-
+
+
+
-
+
-
Prediluted Olympus reagents used
DTL Manual Bench Results
Method
-B
-A
-A,B
A1
A2
B
O
I.S.
4+
-
4+
4+
3+
-
-
RT 30’
4+
MF
4+
4+
3+
-
-
Donor #4
Immucor Gamma-clone reagents used
MF=mixed field
Donor Testing Laboratory Results
Case #5
PK7200 Data Log Results
Donor #2
ABO
Rh
-B
-A
-A,B
D1
D2
Control
A1
B
???
Pos
-
-
-
+
+
-
?
+
Prediluted Olympus reagents used
DTL Manual Bench Results
Method
I.S.
-B
-A
-A,B
A1
A2
B
O
-
-
-
w
-
4+
-
NA
-
-
1+
w
NA
-
Donor #2
RT 30’
Immucor Gamma-clone reagents used
Donor Testing Laboratory Results
Case #6
PK7200 Data Log Results
Donor #2
ABO
Rh
-B
-A
-A,B
D1
D2
Control
A1
B
???
Pos
-
+
+
+
+
-
-
-
Prediluted Olympus reagents used
DTL Manual Bench Results
Method
I.S.
-B
-A
-A,B
A1
A2
B
O
-
4+
4+
-
-
-
-
-
NA
NA
-
-
-
-
Donor #2
RT 30’
Immucor Gamma-clone reagents used