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O Positve Blood To O Negative Blood

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I have always had O positive blood, even recorded in SMR and other hospitals. Last year I was sent a statement that my blood type is O negative. Is there a way that blood types can change????

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I would have the blood test reviewed.If you are O neg and get positive blood you can have real complications

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Blood Groups Types Explained

Author: Administrator

Saved From: http://www.knowledgebase-script.com/demo/article-326.html

When your practitioner tells you your "blood type", you are being given two pieces of information - your

Blood Group and your Rh Status.

1. Your blood group will be A, B, AB, or O. If you have "A" "B" or "O" blood group, you have antibodies in your blood plasma that destroy some of the other blood groups. If you have group "A" blood, you

cannot receive blood that is group "B" and vice versa. If you have "O" blood, your body will create

antibodies to fight "A" or "B" blood. If you have group "AB" blood however, your body will not create

antibodies for any of the other blood groups.

2. Your Rh status will be listed as negative (-) or positive (+). If you have Rh- blood, your body may form antibodies against Rh+ blood and destroy it. In order for this to happen, you must first be exposed to Rh+ blood (i.e., through a blood transfusion or carrying an Rh+ fetus). This can be a problem if you

have antibodies against Rh+ blood and are pregnant with an Rh+ fetus. However, there is medication

that can prevent this reaction from occurring if it is given immediately after you are exposed to Rh+

blood.

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It just seems strange that doctors before navy said that it was positive and doctors within the US Navy typed me positive. I donated blood for years to the Red Cross and they typed me positive.

All of a sudden the VA says, "Oh, by the way, you are O negative blood type."

I know about the blood types and RH factors. What my question was about is, can blood types Change (RH)..??

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This was the only cases I found on Google.

Reconciling conflicting results for Rh typing using different test reagents

A colleague on the US East Coast reports that his laboratory is trying to resolve an interesting

Rh typing problem in a female patient whose initial Rh(D) typing in June 2000 (as part of prenatal

testing) was negative using a monoclonal/polyclonal blend anti-D typing reagent. The patient

was seen a few months later in November 2000 at another hospital, at which time she typed

group O Rh negative, but this time with a "weak Du" result. In spite of her "weak Du" typing

result at the other hospital, she was "treated" as an Rh negative individual, and would have

received Rh Immune Globulin at the time of her delivery, if her baby had been Rh positive. The

baby apparently was Rh negative. As part of trying to resolve the discordant results from her

initial Rh typing, a records review revealed that the two hospitals were using different

manufacturers’ monoclonal/polyclonal blend anti-D typing reagents during 2000.

The patient returned to the inquiring colleague's hospital for prenatal care during a subsequent

pregnancy in December 2002, at which time she showed weak D typing results. A Kleihauer Betke

stain was negative, which seemed to rule out the weak positive reaction being due to fetal cells.

The Rh typing of December 2002 was done with a different manufacturer's monoclonal/polyclonal

blend anti-D typing reagent than that used in the June 2000 Rh typing, but interestingly, the

December 2002 Rh typing was done with reagents from the same manufacturer as that used by

the other hospital in 2000, when a "weak Du" result was reported. To make matters even more

complicated, her "Du typing" result is currently weakly positive when using an AHG IgG heavy

chain reagent, but is 2+ when using a broad spectrum AHG reagent. In addition, her red cells

absorb anti-D and the absorbed anti-D can be eluted from her cells.

Has any colleague experienced a similar case? The manufacturer of the AHG reagent apparently

has no prior similar experience. Are there QC implications for the AHG reagent that were used in

this case? The inquiring colleague reports that his lab will be receiving an alternate source of antihuman

globulin to examine what effect that reagent has on the strength of the reactions seen.

The following responses were received.

ADDENDA Feb. 4, 2003

1. Marilyn Moulds, VP Reference and Education, Immucor Inc./Gamma Biologicals Inc.

(attribution used with permission), refers the e-network forum to the abstract S71-040A in

Transfusion on page 20S from this year's AABB meeting, on "Reactivity of FDA-approved

monoclonal Anti-D reagents with Partial D RBCs" by Judd, Moulds and Schlanser. In her opinion

(verbatim) "I think this reinforces John Judd's suggestion or recommendation that the weak D

test NOT be done on prenatal patients. As to the sample mentioned in the article, it could very

well be a partial D VI person who could make alloanti-D, or it could be a quantitative weak D

that would not produce alloanti-D. As to the antiglobulin sera, IgG vs Polyspecific (broad

spectrum), are the reagents made by the same manufacturer? Are they rabbit or monoclonal

reagents? If rabbit Anti-IgG, the rabbits used in the Polyspecific reagent are more than likely

different than the ones used to make the IgG reagent. If it is monoclonal, then the Anti-IgG is

the same as the one in the Polyspecific reagent."

2. Sheryl A. Kochman, Chief, Devices Review Branch of CBER/OBRR/DBA, (Phone 301-

827-6123), (verbatim) comments: "To understand what is going on here, it is helpful to

understand how the monoclonal/polyclonal blend Anti-D reagents function. Current

monoclonal/polyclonal blends, as the name implies, consist of material of monoclonal origin

(from one cell line) and material of human origin (polyclonal). Each of these components have a

different function. Initially, no licensed monoclonal anti-D were capable of reacting with D

category VI partial D cells and reactivity with other partial D cells was also variable. On the plus

side, these monoclonal anti-D's are very avid and generally react strongly at immediate spin

with cells that are clearly D+ and most weak D (Du cells). However, since no monoclonal

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antibody alone was suitable for testing donor blood, the initial solution to that problem was to

add human polyclonal anti-D, which does detect partial D's and other weak D cells that

monoclonal antibodies may miss, at the antiglobulin phase.

The more current solution to the problem of monoclonal antibodies that do not detect partial D

cells is to blend them with a new monoclonal anti-D that does react with partial D cells,

including D category VI, at the antiglobulin phase. These reagents are named Anti-D

(Monoclonal Blend).

It is important to refer to the "Limitations" and "Specific Performance Characteristics" of the

manufacturers' package inserts to see what is known about the monoclonal anti-D.

I suspect that in this case, the woman has an extremely weak expression of the D antigen or a

weak partial D phenotype. At this time, I cannot explain the difference in reactivity between

polyspecific and Anti-IgG anti-human globulin.

Because individuals with the partial D phenotype have been reported to make antibody to the

parts of the D antigen they are missing, they should be treated as D negative if a patient or

pregnant woman. Donors should be treated as D+, although it is unknown if exposure such a

weak expression of the D antigen can cause an immune reaction."

ADDENDA Mar. 25, 2007

3. A physician affiliated with a blood bank service at a general hospital in Sparta, Greece

reports a case of an 82-year old man who was admitted April, 2006 because of a hip fracture.

At that time and during a follow up admission in May 2006, the patient typed as group O Rh

positive (CcDee, not Du) using gel micro-column agglutination (DiaMed-ID MTS™,

ABD/Rh card, human antibodies) and slide agglutination techniques with two different

blended monoclonal/polyclonal anti-D reagents that reportedly do not detect DVI Rh variant in

direct testing (Ortho and DiaMed). Several different experienced technologists reported the

patient as Rh positive. The patient was transfused with 4 units group O Rh positive RBCs.

During the May 2006 admission the patient was diagnosed with myelodysplastic syndrome.

The patient had no other admission (or transfusion) at any institution until January 2007 when

he was admitted for severe anemia. In January 2007 he typed as group O Rh negative

(ccdee) using the same methodology (and same manufacturer's reagents) as were used in

April and May 2006. Antibody screening, DAT and Du testing with an indirect antiglobulin test

(IAT) were negative and the patient was transfused with group O Rh negative blood. During a

March 2007 admission he again typed as group O Rh negative (ccdee) but Du testing with

IAT conventional tube method was positive (2+ using polyspecific AHG rabbit IgG, DiaMed)

without any mixed-field picture in a micro-column gel test. No elution technique for absorbed

anti-D was carried out. The inquiring physician wonders if for practical reasons, such as limited

group O Rh negative blood supplies, should management of this patient be based on the

previous blood type records which showed the patient to be Rh positive, or should they rely on

current Rhesus phenotype results? He wonders if a molecular analysis would be of clinical

value to define the Rh status.

ADDENDA June 11, 2008

4. A Clinical Laboratory Manager of a Transfusion Service in Wisconsin reports that his

laboratory currently uses a commercial reagent that consists of a blend of monoclonal IgM

and monoclonal IgG antibodies (Reagent A) for routine anti-D typing. For prenatal

patients, however, they use a different commercial anti-D typing reagent that consists of

a blend of human monoclonal IgM and human polyclonal IgG (Reagent :(. Their reasoning for

using Reagent B for prenatal patients is that it reportedly does not react in direct tests

with Partial D types DVa, DVI.1, DVI.2, DFR, DBT, and R0Har. The inquiring institution

does not want to categorize individuals with such Partial D types as Rh positive, because they

believe those individuals should be potential candidates for Rh immunoglobulin

(RhIG) prophylaxis and should be transfused with Rh NEGATIVE cellular blood

components

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