5 January 2025 (Sunday) - Transfusion Dependent

So… a group & save comes in on a four-year-old child with a generic diagnosis on the accompanying form. I was rather busy so I just put the thing through the analyser. The analyser wasn’t having any of it, so as my son once told his primary school teacher, if you want a job done, do it yourself.
Given that the child had a historical blood group of O Rh(D) Negative I was rather surprised to see mixed field reactions with anti-A and with anti-D. Obviously I’d stuffed something up so I did it again and got the same result.
I then delved into the child’s history.
 
The child had thalassemia major. Having had in-utero transfusions before birth he was having regular transfusions every couple of months. Bearing in mind pedipacks are all O Rh(D) Negative that’s what he’d been getting, as do all small children needing transfusions. And having been started on O Rh(D) Negative, that’s what he stayed on.
 
It looks like the child is actually A Rh(D) Positive – there’s no anti-A reaction in the reverse group, and where else would the A Rh(D) Positive part of the mixed field reactions be coming from?
BUT… how can we determine the child’s actual group bearing in mind his condition means he will never be off of blood transfusions long enough for his own group to come through?
 
I posed this question on the Facebook Blood Bank Professionals Group. It was interesting how many people posted responses without actually reading what I’d actually written.

No comments:

Post a Comment