Unidentifiable Information and Courses from MediaLab, Inc.
These are the MediaLab courses that cover Unidentifiable and links to relevant pages within the course.
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| The patient's red cell eluate initially was unidentifiable, reacting weakly with only two panel cells that did not fit a pattern. Once anti-Jka was identified, a check of the eluate panel results showed that both reactive cells were Jk(a+b-) but two other JkaJka panel cells did not react.Consider the question below, then click on the answer. | View Page |
| Summary This case study presents a scenario in which a patient had an unexpected antibody that disappeared after he was transfused with 2 units of unmatched group O Rh negative RBC. The patient developed a positive DAT with MFA but an antibody identification using the post-transfusion red cell eluate was inconclusive, making the antibody unidentifiable. Fortunately, the patient improved and further transfusion was not required. Ultimately, the patient's antibody was identified as anti-Jka, with a second antibody to a low frequency antigen (Radin) also unexpectedly present.The case illustrates the risks involved in using unmatched blood. | View Page |
| Other post-transfusion tests The patient's post-transfusion plasma was also retested with the 6 RBC that tested positive initially. Like the antibody panel done on the post-transfusion plasma, they are now all negative by gel IAT.Unfortunately, the panel results with the patient's post-transfusion eluate do not give clear results (only cells #1 and #9 react) and the antibody remains unidentifiable. Suppose that the physician had decided to continue transfusing the patient at this stage. Take a moment to think about what you would advise regarding the compatibility of such transfusions, all of which appear to be compatible in the crossmatch. When you have considered the options, continue to the next page. | View Page |
| Investigating weak antibodies In this case the patient's antibody has disappeared from the plasma by adsorbing to transfused donor red cells. It is detectable but unidentifiable in the post-transfusion red cell eluate. Several trial and error procedures exist to enhance weak antibodies. Which methods will enhance the reactivity of a given antibody depend on its characteristics. Methods to investigate weak antibodies include: Use a higher plasma to red cell ratio (add more antibody-containing plasma or eluate) Increase incubation time (if consistent with manufacturer instructions, if applicable) Use enzyme-treated panel red cells (enzymes enhance IgG antibodies in Rh and Kidd blood systems but denature some antigens, e.g., Fya, Fyb, S) Try alternative antibody detection methods, e.g., if using LISS routinely, try polyethylene glycol (PEG) or column agglutination methods such as gel, providing they have been validated for use in the TS laboratory. | View Page |
| When the patient's plasma was non-reactive with panel cells, and very weak and unidentifiable in the post-transfusion RBC eluate, no attempt was made to try to enhance the weak antibodies.We now know that the patient has anti-Jka and that it disappeared rapidly from the patient's plasma after transfusion with two group O Rh-negative RBC. Consider the question below, then click on the question to receive the answer. | View Page |