Question

1. Janice Q., blood bank tech, is working in evening shift. As she normally do, she search for the transfusion patient history, and patient has no previous ABO and Rh. She obtained the ABO and Rh results below.

ABO testing Results
Forward Typing		Rh Typing	Reverse Typing
Anti-A	Anti-B	Anti-D	A1	B
4+	4+	4+	2+	2+

Janice repeated the testing, but results are still the same. She decided investigate further and look up the patient medical records on file. She found out that the patient has multiple myeloma, and the patient is currently in the hospital due to septicemia.

1. Which part of typing is discrepant? Is it the forward or reverse typing?

2. Explain your answer in #1.

3. What should be the next step to resolve the discrepancy?

4. What causes this ABO discrepancy?

5. Describe the step-by-step procedure on how to resolve this ABO discrepancy.

Answer 1

Which part of typing is discrepant? Is it the forward or reverse typing? Explain.

Reverse typing.

The patient's blood serums tested for the presence of ABO antibodies . Since the technician cannot confirm the result the test is repeated and confirmed multiple myeloma.

What should be the next step to resolve the discrepancy?

If transfusion is unavoidable before resolving the Rh typing discrepancy the recipient must receive Rh negative blood components.

What causes this ABO discrepancy?

It developed while the results of red cell typing did not match with plasma typing or previous and present results do not match.

Describe the step-by-step procedure on how to resolve this ABO discrepancy.

In this scenario the discrepancy can be resolved by resuspending and washing patient's RBC in saline solution followed by repeated forward typing with anti-A and anti-B . Always retest first to confirm the discrepancy.