Importance of Transplantation History in ABO Discrepancies

Christina Thompson; Marianela Neal; Nicole Peters

doi:10.29074/ascls.18.1.5

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Christina Thompson, EdD CLS(NCA) MT(ASCP)SBB⇑
1. is Clinical Laboratory Sciences Program Director, Texas A&M University-Corpus Christi, Corpus Christi TX
Marianela Neal, MT(ASCP)SBB
1. is Blood Bank Supervisor, Christus Spohn Shoreline, Corpus Christi TX
Nicole Peters, MT(ASCP)
1. works in the Blood Bank, Christus Spohn Shoreline, Corpus Christi TX

Address for correspondence: Christina Thompson CLS(NCA) MT(ASCP) SBB, Clinical Laboratory Sciences Program, Texas A&M University-Corpus Christi, 6300 Ocean Dr, Corpus Christi TX 78412. (361)-825-2473, (361) 825-3719 (fax). cthomp{at}falcon.tamucc.edu

Extract

A complete history is important for the solution of blood bank typing problems and, with the increasing numbers of transplantation procedures, a patient's history may include transplantation at major medical centers with a subsequent return to the local community hospital. If the recipient and donor are different ABO blood types, both stem cell and organ transplantation demonstrate challenging considerations for transfusion support both during and after the procedure. Two cases are presented to demonstrate the importance of a complete history for the solution of ABO typing problems.

CASE 1 A 53-year-old male with a history of multiple myeloma was admitted to the hospital with shortness of breath and a cough. A request for two units of packed red blood cells was received by the blood bank. A review of the patient's history showed diabetes and a stem cell transplant a year ago. Previous blood bank typing revealed a type B positive with no discrepancies. These records also showed that the patient had several previous admissions and had received transfusions of compatible B positive blood and components without complications. Because of the difference in the current blood type, A positive, and the previous type, the patient was recollected and given a second ID wrist band for confirmation. A recollected sample matched the current results and typed as A positive. Current and historical typing results are included in Table 1.

CASE 2 A 57-year-old man was admitted to the hospital unconscious and in septic shock. The patient's blood pressure at admission was…

ABBREVIATIONS: BMT = bone marrow transplantation; PBSCT = peripheral blood stem cell transplantation.