ABO Reverse Discrepancies

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  1. Causes for Weak or Missing Antibodies?
    • Age
    • Immunosuppressed
    • Prozone - Antibody excess - High titer anti-A or B coat all antigen sites on red cell.
  2. Resolution for missing or weak back types for age related or immunosuppressed?
    • Increase incubation time and decrease temperature.
    • Run with antibody screen and autocontrol at same temps and time.
  3. Resolution for missing or weak back type due to prozone affect.
    Dilute the serum and repeat the reverse testing.
  4. Causes for Unexpected Back Type Agglutination.
    • ABO Subgroup 
    • Alloantibodies/Autoantibodies
    • Rouleaux
    • Passively acquired by transfusion of non-identical plasma components.
  5. If testing patient SERUM with A1 Lectin reagent CELLS...
    Negative result = Patient does not have A1 in serum, makes them probably type A2.

    Positive Result = Patient Has antibody making them type as A1
  6. Resolution for unexpected agglutination for back type of ABO subgroup.
    (Most common is A2 and A2B)

    • Test pt serum with additional A1 and A2 red cell reagents.
    • Type pt's cells with anti-A1 Lectin. A subgroups are NONREACTIVE (ie. type A2)
  7. Resolution of unexpect agglutination for allo & auto antibodies for back types.
    • Perform antibody ID then repeat back type with reagent cells that lack the corresponding antibody.
    • Prewarm cells and serum to 37C prior to mixing 
    • Cold autoadsorb pt serum to remvoe the auto, then repeat back type with adsorbed serum.
  8. Rouleaux resolution for back type?
    • Saline Replacement: 
    •           - Serum & cells are centrifuged together
    •           - Serum is then removed from tube & 2 drops of saline are added to replace it.
    •           - Resuspend cell button and observe for agglutination.  
    • True Agglutination will still be present.
    • Rouleaux will have a negative reaction
  9. Passively Aquired ABO antibodies.
    Provide blood that is compatible until passive antibody goes away.
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ABO Reverse Discrepancies

ABO Reverse Discrepancies
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