1. Ruling out using ABID Panel
Please print Antibody Panel 1
It will be helpful to have

2. Panocell for ABID
3. ABID
Look at the panel and check
Phases that have positive reactions
Phase that do not have positive reactions
Are there different reaction strengths recorded?
Are there reactions at differentphases?
Patient auto control
Is it negative or positive?
These are all clues to help with identification
4. Look for Clues
1
Reactions are all at AGH
Reaction strength is different at cell 3
Different reaction strengths can indicate:dosage and/or multiple antibodies
Patient auto control is negative, indicating a possible alloantibody
5. Begin Ruling Out
Use only panel cells that have no reaction recorded in any phase.
Begin with cell #2
Follow with cells #5 and #6
What is left?
6. Ruling Out
When ruling out
Use only cells where no reaction is recorded
Go one cell at a time and mark out antigens that are positive
Watch out for antigens that show dosage
Kidd, Kell, Duffy, MNS, Lewis
If both are present on the cell then can not be ruled out
Look for a pattern to show up especially if only one antibody is present in patient serum
7. Lets begin!
The first cell with a negative reaction is panel cell 2.
Go across cell 2 and mark out all antigens that are positive.
8. Panel Red Cell #2
All positive antigens for panel cell #2 have been marked out except for M and N.
M and N travel together and therefore show dosage.
In order to mark out antigens showing dosage, one antigen must be positive
and the other negative.
9. Continue Ruling out Antigens
Continue ruling out
Use only panels cells where no reaction occurred
After all antigens are marked out look and see what is left.
10. What is left?
After ruling out:
Check what antigens are not marked out
In our example Antigen s and K are not marked out
What are we testing for?
Patient serum/plasma for unexpected antibodies
Antibodies react with:antigens on red cells
Consider the Rule of Three when interpreting results
11. Rule Of Three
There must be three antigens that react positively with the patients serum/plasma.
There must be Three antigens that react negatively with the patients serum/plasma.
If not, use selected cells with or without the antigen in question to meet the Rule of Three
12. What About our Example?
Antigen K
Meets the rule of three
Does not match the reaction pattern
Cannot rule out yet
Antigen s
Meets the rule of three
Does match the reaction pattern
Cannot rule out yet
13. How to Resolve
Phenotype the patient red cells for antigen K and s
If patient is negative for the antigen then the antibody could be present
If patient is positive for the antigen then the reactions would not be from the corresponding antibody
14. Patient Phenotype
The patient is positive for the K antigen; therefore will not make Anti-K.
(Remember Landsteiners Rule!)
The patient is negative for the s antigen; therefore the antibody is most likely Anti-s
15. Interpretation of Results
Based on the panel reactions and the antigen test results:
Our patient has a possible anti-s in his serum/plasma.
When you get a chance, ask if you might review some panels at your clinical site.