Case Based Learning and Textbook Chapter Review Session
September 26, 2007
Textbook Chapters:
Mollison Chapter 8 – Blood grouping technique
AABB Technical Manual Chapters 18 and 19 – Pretransfusion Testing,
Initial Detection and Identification of Alloantibodies to Red Cell Antigens
Case #1
You are on call for the Blood Transfusion Services (BTS) at your healthcare facility which happens
to be a referral center for your health region. You receive a phone call from the medical director of
a local community blood bank who happens to be a general pathologist. There is a patient at their
healthcare facility that requires a two unit red cell transfusion. The initial screen cells are positive
with a possible anti-K pattern. They are unable to fully investigate antibodies and cannot phenotype
red cells.
Question 1:
What is your immediate advice to this physician?
Question 2:
What additional information would you like to know?
Question 3:
What are the transfusion options and timeframes for product availability?
Question 4:
What are the clinical implications of anti-K antibody in pregnancy?
What are the implications for a neonate?
Question 5:
What would be the key issues for the development of a policy for the use of K
negative cells?
Case #2
You are again on call for the BTS at your healthcare facility. You receive a phone call from a
hematology colleague from ER. There is a young patient requiring two units of blood and the BTS
supervisor told them that they are unable to provide compatible blood because of a possible warm
autoantibody.
Question 1:
What is your immediate advice to your hematology colleague?
Question 2:
What additional information would you like to know about the patient?
What additional information would you like to know about the BTS investigation?
Question 3:
What is a biological cross-match and would there be any benefit to performing one
in this patient?
Question 4:
If time were available – how would you perform a cross-match?
Question 5:
If time was not available and blood was required urgently, then what type of blood
would you release?
Question 6:
In patients with AIHA who have received prior red cell transfusions, what is the
frequencies of alloantibodies?
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