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DAT Change of Status

Notice that the patient's DAT is now negative (IAT autocontrol in the panel done 2-weeks post-transfusion is negative).

R2R2
CellRhRhesusKellDuffyKiddMNSsPLewisLuResultsCell


CDEceCwKkKpaFyaFybJkaJkbMNSsP1LeaLebLuaGel
IAT*

1rr000++00+0+0+00++++S+001+1
2rr000++00+0+0++0++++S+00w+2
3rr000++00+0++0+0++0+0+003
4r"r00+++00+0++0+0+0+++0004
5R2R20+++00+00+++++0+0+0+0w+5
60+++00++0+++++0+0+0+0w+6
7R1R1++00+00+00+0++0+0+S0++07
8R1R1++00+00+00++0+00+++001+8
9RZR1+++-+0++0+00++00+++0009
10r'r+00++00+0+00++0+0+S0+0010
11Auto
011



The DAT is now negative because most or all of the transfused donor RBCs have likely been removed from circulation by the patient's anti-Jka.

Red cells sensitized with IgG antibodies such as anti-Jka are trapped in the spleen by macrophages with receptors for the Fc part of IgG molecules. They may also be trapped by macrophages in the liver if they are coated with complement (C3) as well.

Thus anti-Jka usually causes extravascular hemolysis (EVH).

However, because anti-Jka binds complement, some intravascular hemolysis (IVH) may occur if the spleen is overwhelmed by IgG-sensitized red cells and red cells are left in the circulation long enough for them to hemolyze due to C9 binding.