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Meny, G. (N.D.) - Recognizing and Resolving ABO Discrepancies

An ABO discrepancy occurs when the result of an ABO blood type test using red blood cells (forward type) does not match the result of the test using plasma (reverse type). When an ABO discrepancy is encountered, the test should be repeated with the same sample and then with a new sample. If the results still do not agree, the patient's medical records and prior lab tests should be reviewed to resolve the discrepancy. ABO discrepancies can be caused by technical errors in testing or biological factors like unexpected antibodies in the patient's blood. It is important for labs to carefully record any initial discrepant results and follow established guidelines to accurately resolve ABO discrepancies.

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86 views3 pages

Meny, G. (N.D.) - Recognizing and Resolving ABO Discrepancies

An ABO discrepancy occurs when the result of an ABO blood type test using red blood cells (forward type) does not match the result of the test using plasma (reverse type). When an ABO discrepancy is encountered, the test should be repeated with the same sample and then with a new sample. If the results still do not agree, the patient's medical records and prior lab tests should be reviewed to resolve the discrepancy. ABO discrepancies can be caused by technical errors in testing or biological factors like unexpected antibodies in the patient's blood. It is important for labs to carefully record any initial discrepant results and follow established guidelines to accurately resolve ABO discrepancies.

Uploaded by

Valdez Francis Zaccheau
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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2. An ABO discrepancy exists when the result of an ABO RBC typing, or forward type, does not
agree with the result of the plasma typing, or reverse type. It is extremely important in the
clinical laboratory to record these initial discrepant results.
The following list summarizes a general approach that can be followed when an ABO
discrepancy is encountered:
1. Repeat the test with the same sample.
2. Repeat the test with a new sample.
3. Review the patient’s medical record.
4. Review prior in-house laboratory testing records.
5. Contact other healthcare facilities.
6. Verify reagent and equipment performance.

Repeat the test from the beginning using the same sample because plasma and/or RBC
suspensions can be inadvertently mixed up within the laboratory.3 Results and interpretations
may also be mistakenly recorded. When repeating the testing, prepare a fresh RBC suspension,
since a mix-up in sample identification may have occurred during initial testing. Most
laboratories perform initial forward typing using normal saline–washed RBCs. Use normal
saline–washed RBCs if initial typing was performed using plasma-suspended RBCs. If the repeat
results are the same as the first, request a new sample for testing.
Meny, G. (n.d.). Recognizing and resolving ABO discrepancies.
https://www.exeley.com/exeley/journals/immunohematology/33/2/pdf/10.2
1307_immunohematology-2019-012.pdf

ABO discrepancies occur when unexpected reactions occur in the forward or reverse
grouping or the forward typing does not match the reverse typing. In general, RBC and
serum grouping reactions are very strong; therefore reactions less than 3+ usually
represent the discrepancy. In this case, testing patient cells with anti-A gave a 2+ mixed
field reaction and patient cells and anti-D was only a 2+ reaction. 

How this can be solved?


 The first step was repeating the test with the same sample. The repeat tube
typing gave the same results. Additional steps included testing a new sample,
completing the antibody screen, which was negative, and reviewing the patient
history.

ABO discrepancy. (n.d.). Lablogatory. https://labmedicineblog.com/tag/abo-


discrepancy/

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Miscellaneous problems may cause ABO discrepancies, including:

 Cold reacting autoantibodies that result in spontaneous RBC agglutination or a


positive direct antiglobulin test (DAT)
 Mixed red blood cell populations due to massive transfusion
 Unexpected alloantibodies unrelated to ABO antigens
 Unexpected ABO isoagglutinins

Miscellaneous Causes of ABO Discrepancies - LabCE.com, Laboratory Continuing


Education. (n.d.). Www.labce.com. Retrieved January 31, 2021, from
https://www.labce.com/spg813221_miscellaneous_causes_of_abo_discrepancies
.aspx
TECHNICAL ERRORS
 Clerical errors
 Mislabeled tubes
 Patient misidentification
 Inaccurate interpretations recorded
 Transcription error
 Computer entry error
 Reagent or equipment problems
 Using expired reagents
 Using an uncalibrated centrifuge
 Contaminated or hemolyzed reagents
 Incorrect storage temperatures
 Procedural errors
 Reagents not added
 Manufacturer’s directions not followed
 RBC suspensions incorrect concentration
 Cell buttons not resuspended before grading agglutination
Hawre Dlzar. (2013, January 29). Discrepancies.
https://www.slideshare.net/hawre14/discrepancies

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