8 August 2024 (Thursday) - Kobayashi Maru

Time for another BTLP-TACT exercise. I was presented with one case – a thirty-one-year-old chap in the haematology clinic with sickle cell disease needing eight units of blood for an exchange transfusion tomorrow.
He had an indeterminate ABO group presumably from previous exchange transfusions, but his Rh(D) group was negative.
The antibody screen was positive in cells 2 and 3 so I requested antibody panels.
The IAT and enzyme panels were positive in cells 1, 3, 4, 6 and 7 corresponding with anti-Jk(a).
 
I didn’t issue any blood as there was only one suitable unit in the fridge. I got the thumbs down, but (to be blunt) what am I supposed to do when the software gives me this requirement but doesn’t give me eight units of O Rh(D) Negative Jk(a) Negative HbS Negative units to fulfill it?

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