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Ruling out using abid panel

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Ruling out using abid panel

  1. 1. Ruling out using ABID Panel<br />Please print Antibody Panel 1<br />It will be helpful to have<br />
  2. 2. Panocell for ABID<br />
  3. 3. ABID<br />Look at the panel and check<br />Phases that have positive reactions<br />Phase that do not have positive reactions<br />Are there different reaction strengths recorded?<br />Are there reactions at different phases?<br />Patient auto control<br />Is it negative or positive?<br />These are all clues to help with identification<br />
  4. 4. Look for Clues<br />1<br />Reactions are all at AGH<br />Reaction strength is different at cell 3<br />Different reaction strengths can indicate: dosage and/or multiple antibodies<br />Patient auto control is negative, indicating a possible alloantibody<br />
  5. 5. Begin Ruling Out<br />Use only panel cells that have no reaction recorded in any phase.<br />Begin with cell #2<br />Follow with cells #5 and #6<br />What is left?<br />
  6. 6. Ruling Out<br />When ruling out <br />Use only cells where no reaction is recorded<br />Go one cell at a time and mark out antigens that are positive<br />Watch out for antigens that show dosage<br />Kidd, Kell, Duffy, MNS, Lewis<br />If both are present on the cell then can not be ruled out<br />Look for a pattern to show up especially if only one antibody is present in patient serum<br />
  7. 7. Lets begin!<br />The first cell with a negative reaction is panel cell 2.<br />Go across cell 2 and mark out all antigens that are positive.<br />
  8. 8. Panel Red Cell #2<br />All positive antigens for panel cell #2 have been marked out except for M and N.<br />M and N travel together and therefore show dosage. <br /> In order to mark out antigens showing dosage, one antigen must be positive<br /> and the other negative.<br />
  9. 9. Continue Ruling out Antigens<br />Continue ruling out<br />Use only panels cells where no reaction occurred<br />After all antigens are marked out look and see what is left. <br />
  10. 10. What is left?<br />After ruling out:<br />Check what antigens are not marked out<br />In our example Antigen s and K are not marked out<br />What are we testing for?<br />Patient serum/plasma for unexpected antibodies<br />Antibodies react with: antigens on red cells<br />Consider the Rule of Three when interpreting results<br />
  11. 11. Rule Of Three<br />There must be three antigens that react positively with the patients serum/plasma.<br />There must be Three antigens that react negatively with the patients serum/plasma.<br />If not, use selected cells with or without the antigen in question to meet the Rule of Three<br />
  12. 12. What About our Example?<br />Antigen K – <br />Meets the rule of three<br />Does not match the reaction pattern<br />Cannot rule out yet<br />Antigen s –<br />Meets the rule of three<br />Does match the reaction pattern<br />Cannot rule out yet<br />
  13. 13. How to Resolve <br />Phenotype the patient red cells for antigen K and s<br />If patient is negative for the antigen then the antibody could be present<br />If patient is positive for the antigen then the reactions would not be from the corresponding antibody<br />
  14. 14. Patient Phenotype<br />The patient is positive for the K antigen; therefore will not make Anti-K.<br />(Remember Landsteiner’s Rule!)<br />The patient is negative for the s antigen; therefore the antibody is most likely Anti-s<br />
  15. 15. Interpretation of Results<br />Based on the panel reactions and the antigen test results:<br /> Our patient has a possible anti-s in his serum/plasma.<br />When you get a chance, ask if you might review some panels at your clinical site.<br />