The lab received a sample from RD, a 45-year-old renal dialysis patient, for a r
ID: 3516193 • Letter: T
Question
The lab received a sample from RD, a 45-year-old renal dialysis patient, for a routine two-unit crossmatch. Following dialysis treatment, RD would receive the transfusion of the RBC units. The LISS antibody screen revealed an antibody which was consistent with the patient history of an anti-D. Selected D-negative panel cells were tested. Testing revealed an additional antibody, which prompted a selected red cell panel.
Selected Red Cell Panel
Rh
MNSs
P1
Lewis
Lutheran
Kell
Duffy
Kidd
LISS
Cell
D
C
E
c
e
f
CW
M
N
S
s
P1
Lea
Leb
Lua
Lub
K
k
Fya
Fyb
Jka
Jkb
is
37
AHG
5 r’r
0
+
0
+
+
+
0
+
+
+
0
+
0
+
0
+
0
+
+
0
+
0
0
0
0
6 r”r
0
0
+
+
+
+
0
+
+
+
+
+
+
0
0
+
0
+
0
+
+
+
0
0
+w
7 rr
0
0
0
+
+
+
0
+
0
+
0
0
0
+
0
+
+
0
+
+
0
+
0
0
1+
1. What additional antibody(ies) do you suspect?
2. What further testing is necessary?
Rh
MNSs
P1
Lewis
Lutheran
Kell
Duffy
Kidd
LISS
Cell
D
C
E
c
e
f
CW
M
N
S
s
P1
Lea
Leb
Lua
Lub
K
k
Fya
Fyb
Jka
Jkb
is
37
AHG
1 R1R1
+
+
0
0
+
0
0
+
+
+
0
+
0
+
0
+
+
+
0
+
+
0
NT
2 R1R1
+
+
0
0
+
0
+
+
0
0
+
+
0
+
0
+
0
+
0
+
+
+
NT
3 R2R2
+
0
+
+
0
0
0
0
+
0
+
+
+
0
0
+
+
+
0
0
+
+
NT
4 r’r
0
+
0
+
+
+
0
+
0
+
+
+
0
+
0
+
0
+
+
0
+
+
0
0
1+
5 r”r
0
0
+
+
+
+
0
+
+
+
+
+
0
+
0
+
0
+
0
0
+
0
0
0
0
6 rr
0
0
0
+
+
+
0
+
+
+
+
+
+
0
0
+
0
+
+
0
+
+
0
0
1+
7 rr
0
0
0
+
+
+
0
+
0
+
0
0
0
+
0
+
+
0
+
+
0
+
0
0
2+
8 rr
0
0
0
+
+
+
0
+
0
+
+
+
0
0
0
+
0
+
0
+
0
+
0
0
2+
9 rr
0
0
0
+
+
+
0
+
+
+
+
0
+
0
0
+
0
+
0
+
+
0
0
0
0
10 R1R1
+
+
0
0
+
0
+
0
+
+
0
+
0
+
0
+
0
+
0
+
+
0
NT
Auto
0
0
0
NT = not tested
3. What additional antibody is reacting?
4. When a patient has a known antibody, what pretransfusion testing is routinely performed?
5. Do existing antibodies need to be re-identified?
Rh
MNSs
P1
Lewis
Lutheran
Kell
Duffy
Kidd
LISS
Cell
D
C
E
c
e
f
CW
M
N
S
s
P1
Lea
Leb
Lua
Lub
K
k
Fya
Fyb
Jka
Jkb
is
37
AHG
5 r’r
0
+
0
+
+
+
0
+
+
+
0
+
0
+
0
+
0
+
+
0
+
0
0
0
0
6 r”r
0
0
+
+
+
+
0
+
+
+
+
+
+
0
0
+
0
+
0
+
+
+
0
0
+w
7 rr
0
0
0
+
+
+
0
+
0
+
0
0
0
+
0
+
+
0
+
+
0
+
0
0
1+
Explanation / Answer
2. Immunohematologic testing
5. IH - Panel 11, IH - Panel 11 papain, and IH - Panel plus 6 ar e intended for the identification of antibodies to human red blood cells antigens.
IH - Panel 11 papain is intended for use as a supplemental test for complex antibody identification
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