Back Module: SLS144

Competency: 8

This is a compentency for the module "Specialised Transfusion".

Competency information

Details

Select and perform tests for the differential diagnosis of AIHA including:

  • monospecific direct antiglobulin test (DAT)
  • specific antibody identification
  • adsorption elution.

Considerations

  • Types of haemolytic anaemias and their management.
    •  Non-serological:
      • hereditary
      • mechanical anaemias
      • microangiopathy
      • infectious agents.
    • Serological:
      • WAIHA
      • cold – primary CHAD, CHAD secondary to HBV
      • PCH
      • PNH
      • drug-induced
      • combined warm-cold.
  • Monospecific DAT, its uses and the limitations:
    • harmless DAT positives in donors and patients
    • reasons for a positive DAT other than AIHA
    • AIHAs with negative DATs
    • problems with phenotyping DAT-positive patients and application of genotyping in this situation.
  • Autoantibody ’specificities‘ and their effect on transfusion.
  • Practical considerations of selecting and cross-matching blood for patients with autoantibodies.
  • The methods used to detect and identify red cell alloantibodies in patients with warm and cold reacting autoantibodies, and the frequency of testing required where these patients are transfusion dependent.
  • Principles of adsorption elution techniques including
    • situations where autoadsoption is not appropriate
    • selection of cells for alloadsoption.

Relevant learning outcomes

# Outcome
# 2 Outcome Select, perform and interpret the results of non-routine additional tests to elucidate alloantibodies in complex cases (mixtures, high frequency, etc.), and liaise with clinicians and blood services regarding transfusion support.
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