A flow cytometric study of reagent cells to resolve ABO typing discrepancy

Danielle L.V. Maracaja, Jesse Qiao, Tomas Salazar, James Barry, Karen LaForce, Kenneth Holder, John D. Olson

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: RBC alloantibodies can lead to ABO grouping discrepancies unrelated to A or B antigens or antibodies posing challenges in the blood bank testing. Routine blood bank testing and flow cytometry were used to immunophenotype reagent cells and elucidate the cause of ABO discrepancies in two patients. Methods: ABO discrepancy was identified in two patients after transfusion with several units of RBCs. For both patients, the pretransfusion type and screen demonstrated blood group A. Eight and 16 days later, both patients showed an apparent antibody to reagent group A cells, which prompted additional study with patients’ samples and flow cytometric testing of commercial reagent cells. Results: In both patients’ specimens, posttransfusion evaluation demonstrated an emerging antibody to the Kell antigen (K). The RBCs of both patients typed negative for K, and both were transfused with K-positive RBCs. Flow cytometric analysis of reagent RBCs demonstrated that five of seven lot numbers were positive for K. Conclusions: Emerging anti-K antibody led to agglutination of the K-positive reagent A1 cells, highlighting the importance of considering RBC alloantibodies and the composition of reagent cells when interpreting cases with an apparent ABO grouping discrepancy.

Original languageEnglish (US)
Pages (from-to)117-123
Number of pages7
JournalAmerican journal of clinical pathology
Volume155
Issue number1
DOIs
StatePublished - Jan 1 2021
Externally publishedYes

Keywords

  • ABO typing discrepancy
  • Anti-K
  • Flow cytometry
  • Kell alloantibodies
  • Kell-positive reagent cells
  • Posttransfusion discrepancy

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

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