The Antibody Club is now live

You can now work through the first case study to identify which antibodies are present in MJ’s plasma, and then select appropriate tests to find compatible red cells for him.

Complete the eLearning, then join us at the Transfusion Science Symposium at the Adelaide Convention Centre on Saturday 17 October.

You can find the eLearning in Transfusion Online Learning.

The case will be presented and discussed by Chris Hogan, Medical Director, Pathology Services, Australian Red Cross Blood Service. He will also be monitoring our supporting discussion here on transfusion.blog during the month of October, supported by other experts from the Blood Service.

If you can’t join us live in Adelaide, the session will be recorded and made available in Transfusion Online Learning.

Remember our blog will be open from Tuesday October 6 through to Sunday 1 November, so feel free to jump on, ask questions, and participate in the discussions.

Log on to Transfusion Online Learning to enrol in the eLearning and get started.

7 thoughts on “The Antibody Club is now live

  1. Should anti-K was excluded on heterozygous cells?
    Should K be phenotyped for the patient?
    Should we are transfuse K+ units to someone who is prone to making antibodies and statistically is likely to be K-?

  2. Because of the relative rarity of homozygous K cells (the KK phenotype frequency is approx 0.4%) most hospital laboratories would find it difficult to routinely test on other than heterozygous cells. That said ID panels may include a single k- (Cellano negative) cell to assist in excluding anti-k which would otherwise react with all cells on the panel.

    It is acceptable to rule out anti-K with heterozygous cells particularly as the antibody does not show dosage, unlike for example Kidd antibodies, so in fact there is no seroloigical benefit for requiring homozygous cells.

    In the absence of anti-K there is no mandated need to type the patient for K although some labs may do so. Where typing for K becomes important, for example, is if the potential transfusion recipient was a pregnant woman (or a woman with child-bearing potential) or someone who is about to undergo long-term regular transfusions.

    Except for those situations mentioned above (or as per national guidelines) there is no requirement to transfuse K- if the person does not have (or has a history of) anti-K also assuming they are in fact K- . If the person has already made other antibodies (or prior to starting long-term transfusion support) it may be seen as prudent to transfuse red cells that match the recipients extended red cell phenotype which would normally cover Rh, K, Duffy, Kidd and Ss to minimise the risk of forming antibodies against the missing antigens).

    Unfortunately laboratories (especially smaller or remotely located) may not have ready access to suitably phenotyped red cells and would naturally focus on providing those red cells compatible with the antibodies present not those which might possibly develop and so risk transfusing red cells that are positive for antigens the recipient lacks.

  3. Why if Cw is not important is it still on the exclusion matrix template? Will your exclusions be different if this patient was pregnant?

  4. There seems to be a slight misunderstanding around anti-Cw that it is not important or significant. Anti-Cw can be clinically significant (albeit rarely) and is reported to cause both transfusion reactions (mild to severe) and HDFN (mild to moderate). It is therefore necessary to include Cw on the ID panel.

    Unfortunately this case highlights that it is difficult to exclude anti-Cw in the presence of anti-C as Cw+ cells are usually C+ and would require testing by a reference laboratory which has access to the rare C- Cw+ cells. If this case were a pregant woman a paternal phenotype may therefore be informative in assessing the likelihood of the fetus being Cw+ and therefore the potential for maternal anti-Cw; this would be in addition to typing for C and S antigens as well.

  5. Colton a is a high prevalence antigen with 99.9% of the population being Coa positive. Colton b is the antithetical antigen which has a prevalence of about 8% in the Caucasian population and it’s lower in other ethnic groups.

    Colton antibodies are generally IgG and reactive by IAT. They are quite uncommon and have only rarely been associated with mild haemolytic transfusion reactions and HDN. For this reason Co b antibodies are classified as clinically insignificant antibodies, and in most instances laboratories don’t focus on excluding them as part of their investigation process.

  6. I think we need to clarify that anti-Cob should by definition be considered clinically significant since, as noted, it can be found as an IgG antibody active at 37°C by IAT and has been implicated as a cause of transfusion reactions and HDFN.

    However the risk of a transfusion reaction or HDFN is low and therefore what I believe we mean by “insignificnt” is that is it unlikely to cause problems.

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