71 Problem Solving Exercise on Antibody Identification
This exercise is to enhance testing and work performed in the student labs. Exercises are not compulsory but students are encouraged to complete them and then request an answer key from the instructor to keep on track with their learning. If students find they are having difficulty with any exercise they should request additional help from the instructor.
A 29-year-old man was admitted to the hospital in a sickle cell crisis. His hemoglobin level is 62 g/L and his hematocrit is 0.19. The floor requested three units of RC to be available for transfusion. The patient is new to the area so no previous hospital records are available. The patient confirmed a history of previous transfusion. Initial testing reveals the following results:
ABO/Rh Typing
| Anti-A | Anti-B | Anti-D | Rh Control | A1 cell | B cell |
|---|---|---|---|---|---|
| 0 | 4+ | 3+ | 0 | 4+ | 0 |
Antibody Screen
| IS | 37 DEGREES | AHG | CCC | |
|---|---|---|---|---|
| I | 0 | 0 | 0 | 2+ |
| II | 0 | 0 | 2+ | N/A |
| III | 0 | 0 | 3+ | N/A |
The technologist set up a panel; the results are on the following page. Please answer the following questions using the patient results.
- What is the patient’s blood type?
- What antibody(ies) is/are likely present (probable)?
- What antibody(ies) is/are not yet ruled out (possible)?
- What selected cell(s) is/are required (specifically, what antigens are present and “how” are they present)?
- In determining the specificity of the antibody(ies), would enzyme testing be helpful? If so what would the expected results be?
- What additional pretransfusion testing should be performed after the antibody(ies) is/are identified?
