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Blood Bank I: The Fun Just Never Ends
Blood Bank I: The Fun Just Never Ends
Blood Bank I
D. Joe Chaffin, MD
Bonfils Blood Center, Denver, CO
3. IAT variations
a. Unknown antibody check: Use RBCs with a known
antigen profile, as in an antibody screen
b. Unknown RBC antigen check: Use serum with known
antibody specificity, as in RBC antigen testing
c. Can be used to check for an unknown antigen OR
unknown antibody, as in the crossmatch procedure
4. Specificity possibilities for the antiglobulin
a. Anti-IgG, -C3d (“polyspecific”); most common to start
1) Detect red cells coated with either of the above
2) May also detect other immunoglobulins (because
the anti-IgG detects light chains, too)
b. Anti-IgG and anti-IgG (heavy chain-specific)
1) Both detect IgG-coated red cells
2) Anti-IgG used for PEG, gel, and solid phase tests
c. Anti-C3b, -C3d
1) Detects either of the above complement components
2) Most useful in evaluating IgM-related hemolysis,
cold agglutinin disease
5. IgG-sensitized RBCs (“Coomb’s control”, “check cells”)
a. Use after negative DAT or IAT tube test (not gel or
solid-phase) to ensure functioning of AHG reagent
b. Add IgG-coated cells to AHG-cell mixture
c. Negative = bad AHG or no AHG added
d. Other errors (e.g., omitting test serum) missed.
E. Dosage
1. Some antibodies react more strongly with RBC antigens
that have homozygous gene expression.
2. For example, imagine a hypothetical anti-Z
a. Patient 1 genotype: ZZ (Homozygous for Z)
b. Patient 2 genotype: ZY (Heterozygous for Z)