There
was a rather interesting discussion on the report of the latest blood transfusion
NEQAS report:
“Where antibody identification cannot
be concluded using the patient phenotype and results of testing all available
panel cells by IAT and enzyme, additional techniques can be used to make
progress. E.g. the presence of anti-M can be excluded or confirmed using an
antibody panel by direct agglutination at room temperature.
Although
anti-K would normally be expected to react in a 2-stage enzyme technique, it is
advisable to exclude its presence by IAT, since the sensitivity of the 2-stage
enzyme technique can be variable.
Positive
identification requires at least two positive reactions with red cells that
express the corresponding antigen (and are antigen negative for other
specificities potentially present), as a single positive reaction could be a
false positive or
be
due to an antibody to a low frequency antigen
When
interpreting antibody identification results, all available information should
be reviewed, including results of all techniques and of the screening panel1, to ensure that all possible exclusions are made and that
there are no reactions unaccounted for by the antibodies identified.”
I
need to think outside the box a little more in cases like this…
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