Define antibody screen and antibody identification. 2. Differentiate between the
ID: 149733 • Letter: D
Question
Define antibody screen and antibody identification.
2. Differentiate between the importance and use of the antibody screen versus antibody identification regarding each of the following:
a. Potential blood recipient
b. Donor unit
c. Prenatal/Postpartum patients
d. Recently transfused patients with positive DAT (Direct Antiglobulin Test)
e. Neonate with positive DAT
3. State the three phases of testing used in the antibody screen or antibody identification and which type of antibody can be detected in each phase.
4. State the significance of a negative antibody screen.
5. State the significance of a positive antibody screen.
6. Explain the importance of obtaining a patient transfusion and medication history when investigating a positive antibody screen.
7. Given the type of antibody identified, determine the necessary procedure for compatibility testing to provide blood for transfusion for the patient.
8. Explain the purpose of the autocontrol and its relationship to the DAT.
9. Define dosage as it relates to antibody-antigen interactions.
10. Given specific red cell antigen expression, determine if the antigen expression is homozygous or heterozygous.
11. Explain the significance of using screening and panel cells with homozygous antigen expression when performing an antibody screen or identification.
12. Explain the “3 cell rule-in” rule with regard to antibody identification for single or multiple antibodies present.
13. Explain the “rule-outs” rule with regard to antibody identification.
14. Given antibody agglutination results for an antibody identification panel, perform the “3 cell rule-in” and all “rule-outs” to identify the antibody(ies) present.
15. State which blood group antigens are destroyed by enzyme treatment and which antibodies have enhanced expression when tested against enzyme treated reagent red blood cells.
16. Define mixed field agglutination.
17. Describe specific occasions when mixed field agglutination may be present and identified.
18. Given a patient history, current ABO/Rh type, antibody screening and (if applicable) antibody identification results, interpret the testing results.
19. Given a patient history, current ABO/Rh type, antibody screening and (if applicable) antibody identification results, select the appropriate ABO/Rh type of red cell products for transfusion.
20. Given a patient history, current ABO/Rh type, antibody screening and (if applicable) antibody identification results, select the appropriate ABO type of frozen component products for transfusion.
21. Given a patient history, current ABO/Rh type, antibody screening and current or historical antibody identification results, determine the appropriate red blood cell antigen negative blood that would be required for transfusion.
22. For patients in Objective #21, given the antigen frequency of those red blood cell antigens, calculate the number of red blood cell donor units that would need to be screened for transfusion to fulfill the order requested by the physician.
23. Given a patient’s ABO/Rh type and/or other red blood cell antigen phenotyping results, determine the most probable genotype of the patient.
24. Given a patient’s ABO/Rh type and/or other red blood cell antigen phenotyping results, determine the most probable genotype or phenotype of the patient’s parents.
25. Given a patient’s ABO/Rh type and/or other red blood cell antigen phenotyping results, determine the antibody(ies) present in the patient’s serum or plasma.
26. Given donor physical, screening and/or history results, determine if the donor would be accepted, temporarily deferred, or permanently deferred from donating blood products
Explanation / Answer
1. Antibodies are a part of our immune system and target the pathogens and fight them, but sometimes they target the body's healthy cells by mistake. The antibody screen is a test done on the blood of a person to test for such antibodies. The Coomb's test checks for the presence of antibodies which target the red blood cells.
If a person tests positive for such an antibody then a test to identify the antibody has to be done which is called antibody identification. This test identifies the specific red blood cell antibodies that are targeting them.
2. a. Potential blood recipients, as well as donors, need to undergo both, the antibody screening and the antibody identification to avoid any complications and health issues in the recipient. The unexpected harmful antibodies especially alloantibodies in the serum need to be detected and then identified to antigens of the non-ABO blood group system like Duffy, Kell, Kidd, MNS, P, and certain Rh types that are considered clinically significant.
b. One donor unit of blood is about 350 ml of blood. Anticoagulants are added to it to prevent clotting. A screening test is done to test for the presence of harmful antibodies and antibody identification is necessary before it can be transfused into a recipient.
c. Prenatal patients or pregnant mothers who are carrying developing fetus in their womb need both the antibody screening and identification tests so that there is no complication during pregnancy. Harmful antibodies in the mother's blood can target the red blood cells of the fetus leading to serious complications.
d. Positive DAT test means that the person's blood has harmful antibodies attached to his RBC. If such a person is transfused with normal unaffected blood then there might be chances that the RBCs of the transfused blood will also be attacked by the antibodies. Identification of the antibody will help to tackle any complications that might arise.
e. A neonate means a new-born baby. If a baby tests positive for DAT then the next step will be an identification of the antibody to administer the correct treatment.
3.
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