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.
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