Lab Improvement #2 : Further testing for Rh (-) patient

This month we had a Rh (-) patient. A rare occurence in this laboratory. I consulted head of Blood Bank, Hospital Miri for further advice.

After Anti-D testing was found negative, 3 further tests are needed to be done. Du , Rh Phenotyping and DAT. Blood bank Miri must be informed a month before expected date of baby delivery.

Du Protocol

Wash cell x3. Prepare 3-5% RBC suspension. 1 drop 3-5% RBC + 1 drop Anti-D + 1 drop of LISS. Incubate suspension 15 mins at 37 degree Celcius. Spin and observe for agglutination by naked eye. Wash x3 and add 1 drop AHG. Spin and observe agglutination by naked eye and through microcope.

No agglutination seen by naked eye after AHG addition

Microscopic view showing individual cells. No agglutination seen after addition of AHG.

Rh phenotyping (4 tubes labelled as C, c, E & e)

Wash cell x3. Prepare 3-5% RBC suspension. 1 drop of 3-5% RBC suspension + 1 drop Antisera into particular tubes. Incubate 5-10 minutes @ 37 degree Celcius. Then spin and observe agglutination.

DAT

Wash cell x3. Prepare 3-5% RBC suspension. 1 drop of 3-5% RBC suspension + 1 drop of AHG. Spin and observe agglutination by naked eye and microscopic view.