HematologistGuys? (1 Viewer)

[Henry Ford]

Is anyone here a hematologist? Or pathologist maybe, I guess? I have a super weird question I’d like to PM. 

 

[Galileo]

No, but I play one on TV...

 

[Man of Constant Sorrow]

I have a super weird question I’d like to PM. 

Can we guess?

 

[Mrs. Rannous]

Can we guess?

Ooo.  I'm in!

 

[Man of Constant Sorrow]

Ooo.  I'm in!

Yeah - if spotlighting is allowed.

 

[Henry Ford]

Can we guess?

You can, but you’re unlikely to be right. 

 

[Henry Ford]

I’ll give you a hint: monkey transfusion. 

 

[Man of Constant Sorrow]

You can, but you’re unlikely to be right. 

You are not dead.

 

[Man of Constant Sorrow]

I’ll give you a hint: monkey transfusion. 

AIDS?

HIV

 

[Henry Ford]

AIDS?

HIV

No. 

 

[Man of Constant Sorrow]

Sorry - i don't mean that personally

 

[Man of Constant Sorrow]

No. 

BIG HAPPY!

 

[Henry Ford]

It’s professional, not personal. 

 

[Man of Constant Sorrow]

hepatitis type issue in research labs perhaps?

 

[Henry Ford]

I’m wondering, possibility of pregnancy aside, how important is Rh antibody status in a blood transfusion?

 

[Henry Ford]

I see the webmd and other internet stuff... I’m just wondering what a hematologist or blood bank pathologist would actually say. 

 

[Man of Constant Sorrow]

I’m wondering, possibility of pregnancy aside, how important is Rh antibody status in a blood transfusion?

Damn. 

Tough one.

It is only two types (+ & -)?

I honestly can't remember.

 

[Henry Ford]

Damn. 

Tough one.

It is only two types (+ & -)?

I honestly can't remember.

Yeah, the internet basically says “NOOOOOOOOO” to giving + blood to someone who is -, but is that for real? Or just a wive’s Tale?

 

[Man of Constant Sorrow]

Yeah, the internet basically says “NOOOOOOOOO” to giving + blood to someone who is -, but is that for real? Or just a wive’s Tale?

I have no answer.

I doubt I can do a search on it as well as you, but I have some family in the biz.

If I come across them, I will ask their opinion - if it is still relevant to you.

 

[Henry Ford]

I have no answer.

I doubt I can do a search on it as well as you, but I have some family in the biz.

If I come across them, I will ask their opinion - if it is still relevant to you.

Thanks. 

 

[huthut]

I am not a MD or bloodologist, but I wonder if you could take Rhogam like pregnant Rh- women do if the father is Rh, to neutralize anti-rh antibodies. I don't know if there would be a strong reaction like a blood type mismatch, or if the cells would just be cleared really fast.

 

[Henry Ford]

I am not a MD or bloodologist, but I wonder if you could take Rhogam like pregnant Rh- women do if the father is Rh, to neutralize anti-rh antibodies. I don't know if there would be a strong reaction like a blood type mismatch, or if the cells would just be cleared really fast.

I just don’t know.  My big question is whether it’s a big deal for a man to have this mismatch at all.

 

[Terminalxylem]

I’m wondering, possibility of pregnancy aside, how important is Rh antibody status in a blood transfusion?

It's important - if a sensitized Rh - person receives Rh + blood, severe transfusion reactions can result - typically hemolysis (breakdown of the red blood cells +/- low blood pressure). Maternal antibodies can also cause hemolytic disease of the the newborn.

 

[Terminalxylem]

I just don’t know.  My big question is whether it’s a big deal for a man to have this mismatch at all.

Well, the person needs antibodies targeting the Rh factor for the reaction to develop. This most commonly occurs in Rh- women who are exposed to Rh+ fetal/newborn blood during childbirth/pregnancy.

Rh- negative males typically wouldn't have such antibodies, unless they've previously received Rh+ blood through transfusion or needle sharing, for example. While rare, there are case reports of Rh- males with no obvious risk factors with the appropriate antibodies, however.

Does that answer your question? 

 

[Man of Constant Sorrow]

monkey

I just got this.

Rh antibody

Rhesus factor.

I love puzzles.

 

[Man of Constant Sorrow]

Well, the person needs antibodies targeting the Rh factor for the reaction to develop. This most commonly occurs in Rh- women who are exposed to Rh+ fetal/newborn blood during childbirth/pregnancy.

Rh- negative males typically wouldn't have such antibodies, unless they've previously received Rh+ blood through transfusion or needle sharing, for example.

Does that answer your question? 

REally good for me.

Thnx.

 

[DA RAIDERS]

Well, the person needs antibodies targeting the Rh factor for the reaction to develop. This most commonly occurs in Rh- women who are exposed to Rh+ fetal/newborn blood during childbirth/pregnancy.

Rh- negative males typically wouldn't have such antibodies, unless they've previously received Rh+ blood through transfusion or needle sharing, for example. While rare, there are case reports of Rh- males with no obvious risk factors with the appropriate antibodies, however.

Does that answer your question? 

my wife had to take something while preggo, to protect against this.  she is A-.  it's real

 

[ClownCausedChaos2]

Yeah, the internet basically says “NOOOOOOOOO” to giving + blood to someone who is -, but is that for real? Or just a wive’s Tale?

I'm not clinical but I work in healthcare IT, specifically supporting lab/blood bank/transfusions.  It is extremely important.

 

[Terminalxylem]

my wife had to take something while preggo, to protect against this.  she is A-.  it's real

Sure, she got RhoGAM, which is used to prevent development of maternal anti-Rh (technically anti-Rh0 [D] antibodies) in Rh- pregnant women with Rh+ fetuses.

The OP is more interested in males, who are far less likely to develop the antibodies against Rh0 [D], unless they've received a mismatched transfusion or some other exposure to the Rh antigen.

 

[Tom Skerritt]

I am not a MD or bloodologist, but I wonder if you could take Rhogam like pregnant Rh- women do if the father is Rh, to neutralize anti-rh antibodies. I don't know if there would be a strong reaction like a blood type mismatch, or if the cells would just be cleared really fast.

I just don’t know.  My big question is whether it’s a big deal for a man to have this mismatch at all.

The first transfusion of an Rh- male receiving Rh+ blood will likely present no immediate danger. However, any subsequent mismatched transfusions could be serious. That would likely depend on the amount of anti-D antibodies in the Rh- patient, as well as the patient's overall health in general. And I would put it 50:50 as to a potential serious transfusion reaction. 

In an emergency situation where blood is needed immediately, you are going to get whatever blood is available. There is no time for cross-matching. And any transfusion reactions would be dealt with as needed.

And then there are other times where blood has been typed & screened, but the current supply of matching blood products on hand might not be available. In such a case, an Rh- male might need to receive Rh+ blood products. And in such a case however, this would have to be approved by the attending pathologist. This would obviously be noted in the patient's medical record, and everyone would be watching for a reaction. And now that this is in the medical record, presumably everyone should have a heightened awareness if/when any future transfusions are needed.

 

[Henry Ford]

Well, the person needs antibodies targeting the Rh factor for the reaction to develop. This most commonly occurs in Rh- women who are exposed to Rh+ fetal/newborn blood during childbirth/pregnancy.

Rh- negative males typically wouldn't have such antibodies, unless they've previously received Rh+ blood through transfusion or needle sharing, for example. While rare, there are case reports of Rh- males with no obvious risk factors with the appropriate antibodies, however.

Does that answer your question? 

Mostly? Would a hospital intentionally give positive blood to someone who is negative because it just doesn’t matter?

Is it entirely possible that someone who doesn’t present with those antibodies or where those aren’t detected would still have an adverse reaction?

 

[Tom Skerritt]

Mostly? Would a hospital intentionally give positive blood to someone who is negative YES because it just doesn’t matter NO?

I seriously doubt this happens because it "doesn't matter". I'm sure it happens due to lab error, labeling error, or other negligence. But never due to it not mattering.

A scenario exists where a Level I Trauma blood bank only has a minimal supply of Rh- units on hand. An Rh- male presents with a GI bleed and needs a unit of blood. They might consider giving Rh+ blood to this patient in an effort to maintain the limited supply of Rh- blood in case of a trauma event. However, the pathologist would have to sign off on  this mismatched transfusion.

 

[Terminalxylem]

Mostly? Would a hospital intentionally give positive blood to someone who is negative because it just doesn’t matter?

Is it entirely possible that someone who doesn’t present with those antibodies or where those aren’t detected would still have an adverse reaction?

No, a transfusion of Rh + blood would not generally be given to an Rh - individual, regardless of their gender. The only situations it might occur would be  massive trauma (where the patient might bleed out in the time it takes to obtain/crossmatch the blood) or shortage of Rh - blood for an individual requiring emergent transfusion. Or an error is the crossmatch processing.

Not sure I follow your second question, but a person who develops a hemolytic transfusion reaction should have detectable antibodies to Rh0 (D) - if they have a lot of preformed antibodies you’d expect an immediate reaction, if not, it may be delayed as the body ramps up production in response to the antigen.

 

[Terminalxylem]

A scenario exists where a Level I Trauma blood bank only has a minimal supply of Rh- units on hand. An Rh- male presents with a GI bleed and needs a unit of blood. They might consider giving Rh+ blood to this patient in an effort to maintain the limited supply of Rh- blood in case of a trauma event. However, the pathologist would have to sign off on  this mismatched transfusion.

That’s interesting, as I’ve only heard about mismatches occurring due to error or massive trauma. I didn’t realize some blood banks will save some O - blood for potential trauma victims.

 

[Terminalxylem]

That’s interesting, as I’ve only heard about mismatches occurring due to error or massive trauma. I didn’t realize some blood banks will save some O - blood for potential trauma victims.

Reading more about this situation, it appears the Red Cross has policies which promote the use of Rh + blood in Rh - individuals, typically when shortages of Rh - blood exist and they want to save some for Rh- pregnant women and other transfusion dependent patients.

 

[Ketamine Dreams]

Mostly? Would a hospital intentionally give positive blood to someone who is negative because it just doesn’t matter?

Is it entirely possible that someone who doesn’t present with those antibodies or where those aren’t detected would still have an adverse reaction?

Very rarely as outlined above. If we are unable to give crossmatched blood, (due to time constraints), then O - is given. After a certain number of O - units given, usually 3-4, we don't even give type specific then when it becomes available. 

It's possible to have a reaction (allergic), without those antibodies. There are ABO incompatabilities, Rh, and then you get into some of the odd ball ones I don't remember too well: Duffy, Kell etc. 

 

[Man of Constant Sorrow]

I have no answer.

I doubt I can do a search on it as well as you, but I have some family in the biz.

If I come across them, I will ask their opinion - if it is still relevant to you.

Thanks. 

I can't get in touch with my cousin, but she is not going to know anything more than the great answers given so far.

Thanks guys.