Mrs TS is a 69 year old lady who is due an elective total hip replacement. The surgical team request 2 units cross match for the surgery. She has never had a prior transfusion but has had a previous pregnancy.
The sample received for the Group and X match is appropriately labelled with the patient's identification and collectors details including time, date of collection and signature.The patient's group and screen results are as follows:
Please interpret the results.
These are the results of the Extended Antibody identification panel and the donor compatibility screen. Please interpret.
What additional tests would you like to perform?
Patient and donor units phenotypes are listed below:
Describe the phenotypes.
The patient has a forward group of Group 0 positive.
The patient's reverse grouping confirms the result. The expected antibodies were present with anti-A (A1 cells used) and anti- B present.
6 donor units were tested and all came back with a Group O positive group.
The 3 cell antibody screen panel came back positive to all 3 screen cells with a 2+ reaction with Screen cell 1, and 3+ reactions for Screen cell 2 and 3.
An extended antibody identification panel should then be set up. The 6 donor units can also be tested for compatibility with patient's serum.
The extended antibody screen identified 2 antibodies. An anti-K and anti-Fy^a could not be excluded in the patient's serum.
Donor unit testing demonstrated compatibility with the first 2 donor units (6889250 and 7074902) with reactions to all the remaining donor units (7115333, 7084443, 7092214, 6862661).
Both patient and donor units should be phenotype to ensure that the units provided are compatible.
The patient's phenotype is:
Rhesus: D+C+c+E-e+ (RCe/Rce)
Other: K neg, Fy^a neg
The donor units' phenotypes are:
6889250; Rhesus: D+C+c-E-e+ (RCe/RCe)
Other: K neg, Fy^a neg
7074902; Rhesus: D+C+c+E-e+ (RCe/Rce)
Other: K neg, Fy^a neg
7115333; Rhesus: D+C+c+E-e+(RCe/Rce)
Other: K neg, Fy^a pos
7084443; Rhesus: D+C+c-E-e+(RCe/RCe)
Other: K neg, Fy^a pos
7092214; Rhesus: D+C+c+E-e+ (RCe/Rce)
Other: K neg, Fy^a pos
6862661; Rhesus: D+C-c+E+e+ (RcE/Rce)
Other: K neg, Fy^a pos
These phenotypes confirm that it is safe to transfuse donor units 6889250 and 7074902. It is not safe to transfuse the remaining donor units that are all Fy^a positive. These units can cause of haemolytic transfusion reaction if transfused.