Rule-Out Procedures: Selecting Additional Rule-Out Cells-- Example

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The page below is a sample from the LabCE course Antibody Detection and Identification. Access the complete course and earn ASCLS P.A.C.E.-approved continuing education credits by subscribing online.

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Rule-Out Procedures: Selecting Additional Rule-Out Cells-- Example

If a patient is hypothesized to have an anti-Fya after the initial antibody screen and panels are completed but anti-E could not be ruled out, a cell should be selected to do so. This rule-out cell should meet the following criteria:
  1. Negative for Fya (so it will not react with the anti-Fya that has been identified in the serum of the patient).
  2. Homozygous for big E (big E-positive and little e-negative, so that it will react most strongly with anti-E if present).
In the panel shown below, four cells (3–6) meet the first criterion (Fya negative). Of these cells, three (4-6) are big E-positive, and of these, only one cell (4) is homozygous for E (big E positive and little e negative). Therefore, cell 4 would be a suitable rule-out cell in this case.
Rh-HrKellDuffyKiddLewisMNSsPLutheranXg
Donor Cell NumberDCcEeCwKkKpaJsaFyaFybJkaJkbLeaLebMNSsP1LuaLubXga
10++0+00+00++++0++00++0+0
2++00++0+00+0+++00+0++0++
3++00+0++000+0+0+++0++0++
4+0++000+0000+000+00++0++
500+++00+000+0+0++++++0+0
600+++00+0+00+0+0++0++0+0