ABSTRACT
【Objective】 To discuss the interference of anti-CD47 in pre-transfusion test and the mitigation measures. 【Methods】 Blood sample of one patient received anti-CD47 treatment was collected to conduct routine serological tests including ABO/Rh phenotype, direct anti-human globulin test, irregular antibody screening, antibody identification and cross-match. Packed platelet from multiple type O blood donors was used to absorb with patient′s plasma. The patient′s plasma was absorbed with CCDee, ccDEE and ccdee red cells, respectively. Anti-IgG monoclonal Gamma-clone which lacks reactivity with human subclass IgG4 was used to perform antibody screening and cross-match. Capture-R was used to perform antibody screening. 【Results】 The direct anti-human globulin test was positive(1+ ), the reactivity in all phases was strong positive(3+ -4+ ). The anti-CD47 was eliminated after platelet and red cells absorption. Antibody screening became negative using Gamma-clone and Capture-R, and cross-match successfully using Gamma-clone. 【Conclusion】 Anti-CD47 monoclonal antibody can interfere with pre-transfusion test and cross matching. To remove the interference of anti-CD47 requires the use of Gamma-clone anti-IgG in the indirect antiglobulin testing or Capture-R.
ABSTRACT
D antigen is the most immunogenic antigen in the complex Rh blood group system discovered in the year 1939. There is a lot of polymorphism in its phenotype due to genetic heterogeneity. Certain mutations and /or deletions lead to a weak phenotype defined by decreased density of antigen sites which require the use of anti human globulin for detection. The need for detection of the weak D antigen was to prevent alloimmunization by this blood if transfused to a D negative patient especially to women in child bearing age group. This contention is however, controversial and not proven beyond doubt. Moreover, the use of potent monoclonal D typing antisera detects low density of weak D antigens thus obviating the use of anti human globulin. We have assessed the incidence of Rh negative and weak D blood groups in the Garhwal region of Uttarakhand and reviewed the literature regarding the controversies in the clinical significance of weak D antigen.