A 60-year-old woman with anemia is admitted to the hospital. Her hematocrit is 17% and she has been experiencing subtle gastrointestinal bleeding over many weeks. Her physician requests 4 units of red blood cells for transfusion. The patient’s RBCs phenotyped as group AB, D-positive. Her antibody screen is negative on the sample drawn in the emergency room, but her records indicate a previously detected anti-E. Only three group AB, D-positive red blood cell units are available in the blood bank’s inventory. The blood bank’s inventory contains RBC donor units of all ABO and D types.Having located 6 E-negative donor units, you perform crossmatching on the units. One of the units is incompatible in the antiglobulin phase (2+). The physician is becoming insistent on beginning the transfusion, since the patient is having some shortness of breath.How do you respond to the physician’s request?List several reasons to explain the one incompatible donor unit.What additional testing do you perform?

Phlebotomy Essentials
6th Edition
ISBN:9781451194524
Author:Ruth McCall, Cathee M. Tankersley MT(ASCP)
Publisher:Ruth McCall, Cathee M. Tankersley MT(ASCP)
Chapter1: Phlebotomy: Past And Present And The Healthcare Setting
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A 60-year-old woman with anemia is admitted to the hospital. Her hematocrit is 17% and she has been experiencing subtle gastrointestinal bleeding over many weeks. Her physician requests 4 units of red blood cells for transfusion. The patient’s RBCs phenotyped as group AB, D-positive. Her antibody screen is negative on the sample drawn in the emergency room, but her records indicate a previously detected anti-E. Only three group AB, D-positive red blood cell units are available in the blood bank’s inventory. The blood bank’s inventory contains RBC donor units of all ABO and D types.
Having located 6 E-negative donor units, you perform crossmatching on the units. One of the units is incompatible in the antiglobulin phase (2+). The physician is becoming insistent on beginning the transfusion, since the patient is having some shortness of breath.
How do you respond to the physician’s request?
List several reasons to explain the one incompatible donor unit.
What additional testing do you perform?

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