Question

This 19 year old female has been admitted through the ER with a diagnosis of acute appendicitis. A preoperative Type and Screen has been ordered. The ABO/D typing results are listed below. All three screen cells were 4+ at IS, 37C and AHG. All group O units (regardless of D type) gave the same results as the screen cells.

Forward		D		Reverse
Anti-A	Anti-B	Anti-D	D control	A1 Cells	B Cells
0	0	4+	0	4+	4+

1. Interpret each part of the ABO/D type separately. NOTE: If unable to interpret the reactions write or “invalid” as appropriate.
   

	Forward Type	D Type	Reverse Type
Interpretation	O	POS	O

2. The following results were obtained:
   

	Auto Control	Group O Cord Cells	Anti-H lectin
Interpretation	0	4+	0

1. What do the results with the anti-H lectin indicate?

2. What ABO group would give this reaction?

3. What does the testing with the group O cord cells indicate?

3. What is the source of the anti-H?
   
4. State two sources of compatible blood for this patient.   

Answer 1

A. Major percentage of the population (80%) have soluble ABO blood group antigens present in their body fluids. These patients are known as ABH secretors while remaining 20% are non secretors. Secretors contains the following ABH antigens in their body fluids:

O Secretors : Only H A Secretors : A & H

B Secretors : B & H AB Secretors : A, B & H

Non Secretors : None

Human red blood cells possessing H antigen will agglutinate in the presence of seed extract of Ulex europaeus containing phytoagglutinin specifically directed towards it. Saliva also contains water soluble ‘H’ antigen which gets neutralised by Anti-H Lectin. Agglutination of red cells/neutralisation of Anti-H Lectin by saliva is a positive test result and indicates the presence of H substance on/in the red cells/saliva respectively. No agglutination of red cells/neutralisation of Anti-H Lectin by saliva is a negative test result and indicates the absence of H substance on/in the red cells/saliva respectively.

B. The ABO group that the reaction will give is O positive type of blood group. Because of A, B antigens not agglutinated and anti D is present hence positive.

C. Testing with the group O cord indicates all groups O units indicates the same result assscreen cells.

D. Anti-H lectin is a ready to use purified extract of Ulex europaeus seeds. It contains a phytohaemagglutinin which is virtually specific for the H antigen on human red blood cells.

Anti-H lectin is used for recognition of the H antigen on human red blood cells. It is useful, especially for assessing the H secretor status of group 'O' individuals and also in differential grouping of Aint subgroup along with Anti-A1 lectin.

Human red blood cells that do not agglutinate with Anti-H lectin are classified as Bombay Phenotype (Oh). The Bombay Phenotype is more common in India than other parts of the world.

E.the two sources for the compatibile blood for this patient :

People with O positive blood can safely receive red blood cells from :

1.O positive blood group.

2.O negative blood group