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Research Article
A close aspect of recognizing and resolving blood group discrepancy carried in a tertiary hospital, Bangladesh
1 FCPS in Transfusion Medicine, Assistant Professor, Department of Transfusion Medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
2 Masters in Transfusion Medicine, Professor, Department of Transfusion Medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
3 FCPS in Haematology, Medical Officer, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
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Sonia Shormin Miah
FCPS in Transfusion Medicine, Assistant Professor, Department of Transfusion Medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka,
Bangladesh
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Article ID: 100056Z02SM2021
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Miah SS, Islam A, Linia MS. A close aspect of recognizing and resolving blood group discrepancy carried in a tertiary hospital, Bangladesh. Int J Blood Transfus Immunohematol 2021;11:100056Z02SM2021.ABSTRACT
Aims: Blood grouping includes both forward and reverse typing and there is always an inverse reciprocal relationship between this. Any unusual reaction can confer discrepancy and may lead to grave incompatible transfusion reaction. Resolving discrepancy is a crucial part that should not be ignored to save patients life.
Methods: It is a cross-sectional study carried out at a tertiary hospital, over a period of one year. Sample had been selected based on comprehensive history, medical records, physical findings, and laboratory reports. ABO and Rh typing was done by using monoclonal immunoglobulin M (IgM) reagents (Tulip, Lorne and Biorex Diagnostic Ltd.) and A, B, and pooled O cell. Therefore, anti-H and anti-A1 lectin, extended red cell phenotyping, Coombs analysis had also done in few suspected cases.
Results: A total 25,082 blood group testing was done, 318 samples were carried out for group confirmation and discrepancy found in 51 cases. Technical and clerical errors were found in 18 cases. The remaining 33 samples reported as true discrepancy which was detected by Coombs analysis (both direct and indirect), antibody screening, determination of Rhesus genotype and phenotype, and minor antibody detection. The rate of discrepancy is about 0.20%. Meanwhile, missing antigen was found in 3 cases (5.88%), missing antibody in 1 (1.96%), additional reaction due to rouleaux’s in 4 (7.84%), mixed field (mf) reaction due to mismatched blood transfusion in 6 (11.76%), alloantibody with mixed phenotype in 5 (9.80%), cold antibody in 9 (17.24%), and Bombay in 5 cases (9.80%).
Conclusion: Blood group discrepancy is not an uncommon phenomenon. All the critical issues should be sensibly explored, evaluated, and analyzed by the expert physicians to avoid the discrepancy. These common but curable issues can be easily carried out and solved. A careful surveillance can also play a significant role in monitoring the recuperate misidentification problem. Therefore, all the technical staffs who usually play these vital roles should be mannered and clarified in a successful motion, to avoid this type of discrepancies.
Keywords: ABO discrepancy, Incompatible transfusion, Subgroup
SUPPORTING INFORMATION
Acknowledgments
The authors thank the Department of Transfusion Medicine, Bangabandhu Sheikh Mujib Medical University for conducting this study.
Author ContributionsSonia Shormin Miah - Conception of the work, Design of the work, Acquisition of data, Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Ashadul Islam - Acquisition of data, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Mahbuba Sharmin Linia - Conception of the work, Design of the work, Drafting the work, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Guarantor of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2021 Sonia Shormin Miah et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
