02721nas a2200301   4500008004100000020001400041024001700055245015900072210006900231260012500300300001200425490000700437520166900444653004402113653003302157653004402190653000902234653002202243653001802265653001102283653000902294100001602303700001302319700001002332700001502342700001702357856004502374       1996                        eng d  a0041-1132  awdn, 041736000aFatal hemolytic transfusion reaction resulting from ABO mistyping of a patient with acquired B antigen detectable only by some monoclonal anti-B reagents.0 aFatal hemolytic transfusion reaction resulting from ABO mistypin  aUNITED STATESbGarratty,G. American Red Cross Blood Services, Southern California Region, Los Angeles, 90006, USA.c1996  a351 - 70 v363 aBACKGROUND: Some monoclonal anti-B reagents are prepared exclusively from an anti-B clone, ES4, that is known to detect acquired B antigens that are not detectable by other anti-B clones or polyclonal anti-B reagents., CASE REPORT: A 92-year-old group A, Rh-negative man with diverticulitis was mistyped as group AB with the use of a monoclonal anti-B. The hospital did not detect anti-B in the patient's serum. After a negative antibody screen, blood was issued through an abbreviated crossmatch (i.e., immediate-spin crossmatch). The patient was given 3 units of group AB blood and 1 unit of group A blood, and no problems were reported. After the transfusion of a ?fourth unit of AB blood the patient had a severe hemolytic transfusion reaction which resulted in kidney failure and death 10 days later. After the transfusion reaction, the patient's pretransfusion red cells were found to be group A with an acquired B antigen. The monoclonal anti-B used the hospital was formulated from the ES4 clone. A sample of the patient's serum taken before the transfusion was later found to contain a weak anti-B, detectable most obviously by the antiglobulin test, which was not performed at the crossmatch stage. The manufacturers of monoclonal anti-B reagents prepared from ES4 have since modified their reagents (i.e., lowered the pH) so that they now detect only the strongest examples of acquired B antigen., CONCLUSION: A fatal hemolytic transfusion reaction resulted because a monoclonal anti-B that detected acquired B antigen was used to type red cells from an elderly man whose serum had weak anti-B that was not detected by abbreviated compatibility testing.10a*ABO Blood-Group System/im [Immunology]10a*Blood Group Incompatibility10a*Blood Transfusion/ae [Adverse Effects]10aAged10aAged, 80 and over10aFatal Outcome10aHumans10aMale1 aGarratty, G1 aArndt, P1 aCo, A1 aRodberg, K1 aFurmanski, M  uhttps://notifylibrary.org/reference/4427