Ruling out using abid panel
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Ruling out using abid panel






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    Ruling out using abid panel Ruling out using abid panel Presentation Transcript

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