ABO Discrepancies Disclosure Objectives Importance Recognition ...

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4/12/2011 ABO Discrepancies MUST be Resolved In PATIENTS, an ABO discrepancy must be resolved before ANY blood component is transfused. – If an ABO discrepancy cannot be resolved before blood product is needed, transfuse with Group O red blood cell units In DONORS, the discrepancy must be resolved before any blood is labeled with a blood type. Identify the Discrepancy Front Type Reverse Type Patient Anti-A Anti-B Anti-A,B A 1 cells B cells JK 0 3+ 3+ 0 0 Front type: B Reverse Type: AB Theory: Weak reverse type Identify the Discrepancy Identify the Discrepancy Front Type Reverse Type Patient Anti-A Anti-B Anti-A,B A 1 cells B cells KK 4+ 4+ 4+ 3+ 3+ Front Type Reverse Type Patient Anti-A Anti-B Anti-A,B A 1 cells B cells CK 4+ 0 4+ 0 4+ Front Type: AB Reverse Type: O Front Type: A Back Type: A Theory: Additional antibodies in the reverse type Theory: NO DISCREPANCY NOTED Identify the Discrepancy Front Type Reverse Type Patient Anti-A Anti-B Anti-A,B A 1 cells B cells AK 0 w+ 1+ 4+ 0 Front Type: B?? Reverse Type: B Steps for Resolution Recheck specimen for identification Rewash EDTA cell suspension Repeat testing Confirm patient’s t’ diagnosis, i age, medication, and pregnancy history Theory: Weak reacting antigen in the front type. 2
4/12/2011 Types of ERRORS Clerical Errors Mislabeled tubes Patient misidentification Inaccurate interpretations recorded Transcription error Computer entry error Types of ERRORS Reagent or equipment problems Using expired reagents Using an un-calibrated centrifuge Contaminated or hemolyzed reagents Incorrect storage temperatures Types of ERRORS ABO Discrepancy Categories Procedural errors Reagents not added Manufacturer’s directions not followed RBC suspensions incorrect concentration Cell buttons not re-suspended before grading agglutination Problems with Red Blood Cells Weak-reacting/Missing antigens Extra antigens Mixed field reactions Problems with Plasma/Serum Weak-reacting/Missing antibodies Extra antibodies Grouping Forward Reverse Missing/Weak Extra Mixed Field Missing/Weak Extra Subgroup A/B Acquired B O Transfusion Young Elderly Immunocompromised Cold Autoantibody tib Forward Grouping Problems Disease (cancer) B(A) Phenotype Bone Marrow Transplant Cold Alloantibody Rouleaux True Chimera Rouleaux Anti-A 1 3
Page 1: 4/12/2011 ABO Discrepancies Develop
Page 5 and 6: 4/12/2011 Forward Grouping Problems
Page 7 and 8: 4/12/2011 Reverse Grouping Problems
Page 9 and 10: 4/12/2011 Case Study #3: Patient Hi
Page 11 and 12: 4/12/2011 61 Anti-A Anti-B Anti-A,B
Page 13: 4/12/2011 73 References • Harmeni

ABO Discrepancies Disclosure Objectives Importance Recognition ...

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