2 November 2025 (Sunday) - BTLP-TACT Exercise

It’s raining, I’m sulking… Might as well do another BTLP-TACT exercise until the rain stops.

I was presented with two cases:

 

76896 – a fifty-one year old chap needing four units of FFP for bleeding varices.

The control well was weakly positive so the entire group was invalidated and would need referral to NHSBT. The antibody screen was negative.

FFP is NOT recommended for bleeding varices https://pubmed.ncbi.nlm.nih.gov/33969607/  so I didn’t issue any.

 

45944 – a seventy-five year old chap with beta thalassemia needing two units of blood

He grouped as A Rh(D) Positive with antibody screen positive in cells 2 and 3, so I performed antibody panels. The IAT and enzyme panels were positive in cells 2, 3, 7, 8 and 9 corresponding with anti-Le(b) but not excluding anti-Lu(a) or anti-Kp(a)

https://pmc.ncbi.nlm.nih.gov/articles/PMC11747971/ says anti-Le(b) is not clinically significant, and bearing in mind that there were no units available which were Le(b)-negative I treated it as not significant. But there wasn’t any units at all that were Kp(a) negative so I didn’t issue any.

 

I got the thumbs down. Apparently anti-Lu(a) and anti-Kp(a) could be excluded…

I’d like to know how.