Patient George Hamilton, Age 75, White, Dx: Lymphoma ABO/Rh type: Anti-A = 4+ Anti-B = 0 Anti-D = 4+ A1 Cells = 1+ B Cells = 3+ Antibody Screen: Done using Tube Method with LISS Cell #1 37 C = 0 IgG = 0 CC= 2+ Cell #2 37 C = 0 IgG = 0 CC = 2+ Cell #3 37 C = 0 IgG = 0 CC = 2+ Autocontrol 37 C = 0 IgG = 0 CC = 2+ ISXM performed on O Rh Pos RBCs: Unit # W2020 15 432452 1+ Unit # W2020 15 553982 0 Unit # W2020 15 781299 1+ DAT: Poly = 0 IgG = 0 C3= 0 Control = 0 (All Check Cells worked) Discuss the following: Were the units selected for crossmatch selected appropriately? Explain why or why not. What may be causing the discrepant results in the ABO and the pos results in the XM? What additional testing could you do to determine the cause of the discrepancy and the XM incompatibility? Was the crossmatch performed at the correct phases? Explain. How could you resolve the ABO Discrepancy? __________________________ Patient: Joanne Spees Age 24 Female, Black, Married Dx: Pregnant 39 weeks gestation; active labor History in Blood Bank System: O Neg Antibody Screen Negative at 28 weeks; 1 Dose RhIg Administered Current Sample Results: O Neg Antibody Screen Negative Patient is in distress during labor with heavy bleeding. Her HgB is 7.6 g/dL and the physician wants to increase it to 10.6 or higher. Her coag results indicate she is in DIC. The child is delivered and is a boy. He appears healthy despite the traumatic delivery. He is placed under observation. His cord blood results are: ABO/Rh: A Pos DAT IgG: 0 A RhIg study is ordered on the Mother’s postpartum sample; Rosette Test (Fetal Screen) is Pos and the KB Stain that was performed in response to that result demonstrates 72 refractile pink cells in the 2000 total cells counted. (includes ghost cells) Discuss the following: Should the RhIg have been given at 28 weeks? Why or why not? Does the baby have HDFN? Why or why not? How many units of packed RBCs would likely need to be given to increase the mother’s HgB to the level desired by her physician? What other products might need to be given to help in her situation?….explain how each would help. What would her APTT, PT/INR, Fib, Platelt count and DDimer results be when she is in DIC? What is the principle of the Rosette Test compared to the principle of the KB Stain test? Why was the KB stain performed and what information does it give you? How many doses of RhIg, if any, should be given to the mother? How did you determine the dose of RhIg (show all work)?