The patient phenotypes as group AB, D-positive. Her antibody screen is negative on the sample drawn in the emergency department. Patient records indicate a previously detected anti-E. Only three group AB, D-positive RBC units are available in the blood bank’s inventory. The blood bank’s inventory contains RBC donor units of all ABO and D types. After antigen screening of the four units of RBCs for the E antigen, one of the group AB, D-positive units is E positive. Calculate the number of donor units to screen to find the four units ordered plus two more units to hold in reserve for the patient. Having located six E-negative donor units, you perform crossmatches on the units. One of the units is incompatible in the antiglobulin phase (2+ reactivity). The physician is becoming insistent on beginning the transfusion because the patient is having some shortness of breath. How do you respond to the physician’s request? List several reasons to explain the incompatible donor unit. What additional testing do you perform?
The patient
After antigen screening of the four units of RBCs for the E antigen, one of the group AB, D-positive units is E positive.
- Calculate the number of donor units to screen to find the four units ordered plus two more units to hold in reserve for the patient.
Having located six E-negative donor units, you perform crossmatches on the units. One of the units is incompatible in the antiglobulin phase (2+ reactivity). The physician is becoming insistent on beginning the transfusion because the patient is having some shortness of breath.
- How do you respond to the physician’s request?
- List several reasons to explain the incompatible donor unit.
- What additional testing do you perform?
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