A Black male patient aged 21 years with a history of sickle cell disease and HIV was admitted to the hospital with vaso-occlusive crisis. A transfusion reaction was called after the patient developed a fever (39.5°C), tachycardia, chills, and hematuria after receiving 300 mL of red blood cells. A posttransfusion specimen was submitted to the Immunohematology Reference Laboratory for investigation. Antibody identification revealed an anti-Leb as the probable cause of the immediate acute hemolytic transfusion reaction. Lewis antibodies are considered clinically insignificant. This case shows the importance of considering cold antibodies, including Lewis antibodies, as a possible cause of an acute hemolytic transfusion reaction.

Background and objectives A 2-year-old female with neuroblastoma needed In(b-), E-red blood cells (RBCs). No units were available at the blood centre (BC) nor in the rare donor programme member's inventories. BC's Immunohematology Reference Laboratory (IRL) and its marketing department concentrated on recruiting and testing those donors more likely to be antigen negative based on ethnicity.Materials and methods The BC's communication plan utilized social and traditional media to assist in the search for In(b-) blood. Media strategies directed donors in the United States (US) and Canada to go to their nearest BC for collection, tagging and testing of units. Two segments from each donation were shipped overnight to the BC's IRL (associated with the patient) for testing. Diluted anti-Inb sera was tested by microtechniques to conserve resources. Additionally, the American Rare Donor Program (ARDP) facilitated the international searches and acted as a liaison to the Food and Drug Administration (FDA).Results More than 25 000 people responded to the appeal. Seventy-seven BCs submitted segments from 4197 units. Two donors were In(b-) but E+ and thus not compatible with the patient but were submitted to ARDP for future needs. The prevalence of In(b-) units identified in the search was 0Á048%. In total, five known In(b-) donors, two from the US and three from international sources, provided units for this patient.Conclusion Social media sparked a viral response to the rare blood need. While a match was not found among the units tested, domestic and international searches were able to meet the patient's blood needs.

Objective To test a hybrid polyethylene glycol (PEG)/gel method, specifically to attempt to increase reaction strength of accidentally overdiluted anti-Cob and broadly for proof of concept. Methods Methods were divided into 2 basic steps: sensitization and antiglobulin (AHG) testing. Sensitization was performed with PEG tubes, followed by AHG using the gel method. One wash was performed between the 2 steps. We tested 7 plasma antibody specimens. Results In addition to the first specimen, 6 additional antibodies were selected for detection by the PEG/gel hybrid method. Antibody reactivity was detected in all specimens tested with both methods. The PEG/gel method yielded enhanced reactivity in 3 of 7 antibodies (42.9%) and the equivalent of enhanced reactivity in 4 of 7 antibodies tested (57.1%). Conclusion The reactivity of diluted anti-Cob (specimen 1) was increased; thus, our concept proved to be viable. The hybrid PEG/gel method showed the equivalent of enhanced or enhanced reactivity with all specimens tested and provided a stable medium.

Background: In addition to antigen-negative red blood cells (RBC), Immunohematology Reference Laboratories (IRL) must provide RBCs that are cytomegalovirus (CMV) seronegative. Due to high percentage of CMV seropositive individuals, it is challenging to find CMV and antigen-negative RBC. The IRL selects predominantly group O donors tested for CMV, and these RBC are sometimes needed to fill orders for nongroup O patients. This study evaluated units sent that were out of group to fulfill CMV-seronegative requests.Study Design and Methods: Requests for CMV-seronegative and antigennegative RBCs were divided into Period 1 (January 1, 2019-February 29, 2020) before intervention and Period 2 (March 1, 2020-May 31, 2020) post intervention. ABO Rh units requested were compared to ABO Rh units provided. Results: Period 1: 537 CMV-seronegative RBC units were provided. 99/188 (52.66%) B-positive requests were fulfilled using O RBCs. 58/504 (11.51%) of D-negative units were sent to D-positive patients.