The hard-won m-antigen negative blood

2022-07-19 0 By

On January 19 at 3 o ‘clock in the afternoon, jiangxi province tumor hospital blood transfusion department duty room telephone suddenly rang, originally is the gynecological tumor second ward call consultation, a patient in the local hospital examination found irregular antibody screening positive, cross match blood is not, now is preparing to transfer to our hospital, ask whether the blood transfusion department can solve this problem?My department on duty staff Zhou Huangyan answered without hesitation, yes!At 5pm, the patient was admitted to the hospital in emergency. The blood routine results showed that the hemoglobin was 44g/L, and blood transfusion was urgently needed.After receiving the blood samples, Zhou Huangyan underwent blood group identification immediately, among which ABO blood group results were anti-A negative, anti-B double group phenomenon, self-control negative, Ac positive 4+, Bc negative and Oc negative. After consulting the patient’s medical history, her previous blood group results in our hospital were B-type RhD positive.The double group antibody phenomenon is mainly seen in heterotype blood transfusion, ABO subtype, leukemia antigen weakening, bone marrow transplantation, hematopoietic stem cell transplantation, twin chimera, fetal and maternal transfusion syndrome, etc. Combined with the patient’s medical history, it is highly suspected that the patient has a history of O red blood cell transfusion.Zhou Immediately contacted the clinical department to ask the patient’s medical history, and confirmed that the patient had received 8U O RhD positive red blood cells in a total of 3 consecutive days from January 15 to 17 in the local hospital.So far, we have confirmed that the patient’s blood type is TYPE B RhD positive, and infusion of Type B RhD positive red blood cells should be the first choice.Huang Yan Zhou further screened the patient’s plasma for irregular antibodies, and the results showed positive results by saline method and microcolumn gel method. It was considered to be IgM irregular antibodies, combined with the pattern of anti-screening red blood cell antigen, and was initially suspected to be anti-M antibodies in the MNS system.In view of the patient’s critical condition, Zhou huangyan decided to blindly match 2u B RhD positive red blood cells to relieve the patient’s hypoxia symptoms and signs.At 8:00 a.m. on January 20, Zhou Huangyan went to the clinical laboratory to collect biochemical, blood routine and coagulation samples of the patient after the night shift, and then took all the samples to the Blood Transfusion Department of the Second Affiliated Hospital of Nanchang University for antibody identification, confirming that the irregular antibodies in the patient’s plasma were anti-M antibodies.In the MNS system, patients’ red blood cells could be divided into three phenotypes: MM, MN and NN.Anti antibodies with MM phenotypic erythrocyte agglutination reaction can lead to cross with blood, but with MN phenotype blood red blood cells may appear type and false negative phenomenon, although cross matching and consistency, M antibody positive patients after infusion MN phenotype of red blood cells will still produce hemolytic transfusion reaction, so the NN phenotype of red blood cells is the best choice for M antibody positive patients.Immediately, Zhou Huangyan screened 3 bags of NN-phenotype red blood cells from 25 bags of red blood cells, and confirmed again that these 3 bags of red blood cells were consistent with the patient’s cross matching blood.At 12:00 noon, Zhou huangyan sent the three bags of red blood cells back to the department and contacted the management doctor to inform the patient that the blood transfusion problem had been completely solved.On January 20, the patient’s hemoglobin was 65g/L.On January 22, the patient’s hemoglobin was 83g/L.Seeing the patient’s hemoglobin steadily achieved the desired effect, Zhou huangyan smiled happily on her face.(Written by Lu Saiping)