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Donor ABO Blood Grouping Discrepancies Heather Hume Greg Denomme CBS HO Serology Laboratory Feb 20, 2009.

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Presentation on theme: "Donor ABO Blood Grouping Discrepancies Heather Hume Greg Denomme CBS HO Serology Laboratory Feb 20, 2009."— Presentation transcript:

1 Donor ABO Blood Grouping Discrepancies Heather Hume Greg Denomme CBS HO Serology Laboratory Feb 20, 2009

2 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.

3 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

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5 GL GAL GLNAC GL GAL GLNAC GALNAC GL GAL GLNAC GAL Group ‘O’ Antigen Group ‘A’ Antigen Group ‘B’ Antigen

6 Basic ABO Grouping Forwardgrouping ReversegroupingABO group Anti-AAnti-BA cellsB cells neg pos O neg pos A negpos neg B pos neg AB

7 ABO Blood Grouping Discrepancies Missing reactivity? –apparent absent antigen –apparent absent antibody Additional reactivity? –apparent extra antigen –apparent extra antibody

8 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

9 Donor Testing Laboratory Results Case #1 Donor #2 ABORh-B-A-A,BD1D2ControlA1A1 B ???Pos-?+++--+ PK7200 Data Log Results Prediluted Olympus reagents used Donor #2 Method-B-A-A,BA1A1 A2A2 BO I.S. --2+--3+- RT 30’-1+2+--3+- Immucor Gamma-clone reagents used DTL Manual Bench Results

10 Donor Testing Laboratory Results Case #2 Donor #5 ABORh-B-A-A,BD1D2ControlA1A1 B ???Pos---++--+ PK7200 Data Log Results Prediluted Olympus reagents used Donor #5 Method-B-A-A,BA1A1 A2A2 BO I.S. -----2+- RT 30’---2+-3+- Immucor Gamma-clone reagents used DTL Manual Bench Results

11 Donor Testing Laboratory Results Case #3 Donor #3 ABORh-B-A-A,BD1D2ControlA1A1 B ???POS--+++--+ PK7200 Data Log Results Prediluted Olympus reagents used Donor #3 Method-B-A-A,BA1A1 A2A2 BO I.S.--MF3+ 4+2+ RT 30’--MF3+ 4+ DTL Manual Bench Results Immucor Gamma-clone reagents used MF=mixed field

12 Donor Testing Laboratory Results Case #4 Unit returned to CBS - Labelled B pos, tested AB pos at hospital Donor #4 ABORh-B-A-A,BD1D2ControlA1A1 B BPOS+-+++-+- PK7200 Data Log Results Prediluted Olympus reagents used Donor #4 Method-B-A-A,BA1A1 A2A2 BO I.S.4+- 3+-- RT 30’4+MF4+ 3+-- DTL Manual Bench Results Immucor Gamma-clone reagents used MF=mixed field

13 Donor Testing Laboratory Results Case #5 Donor #2 ABORh-B-A-A,BD1D2ControlA1A1 B ???Pos---++-?+ PK7200 Data Log Results Prediluted Olympus reagents used Donor #2 Method-B-A-A,BA1A1 A2A2 BO I.S. ---w-4+- RT 30’NA--1+wNA- Immucor Gamma-clone reagents used DTL Manual Bench Results

14 Donor Testing Laboratory Results Case #6 Donor #2 ABORh-B-A-A,BD1D2ControlA1A1 B ???Pos-++++--- PK7200 Data Log Results Prediluted Olympus reagents used Donor #2 Method-B-A-A,BA1A1 A2A2 BO I.S. -4+ ---- RT 30’-NA ---- Immucor Gamma-clone reagents used DTL Manual Bench Results


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