Although far from the spotlight, medical laboratory scientists and other laboratory professionals play a vital role in health care and patient outcome. The work of testing, diagnosing, and treatment is crucial in saving lives—but the Red Cross takes laboratory services a step further.
Improving patient care through innovation and decades of research lies at the forefront of the laboratory services at the Red Cross. Thanks to a legion of medical laboratory professionals, including Dr. Margaret Keller, Dr. Bethany Brown, and Dr. Eric Gehrie, the capabilities of labs extend to bettering patient care by providing diagnostic results and collaborating with researchers across the globe in improving blood collection and storage. Here we share two intriguing case studies that demonstrate the far-reaching work and skill of the American Red Cross Immunohematology (IRL)labs.
In this article Emily Wilson MT(ASCP)SBB and Karen Rodberg MBA, MT(ASCP)SBB review a case of a donor with McLeod phenotype that was discovered in the IRL following during routine donor antigen screening.
A sample of the unit was shipped to the American Red Cross in Southern California and National Molecular Lab in Philadelphia for investigation. The serological testing confirmed the donor to lack the Kx antigen and have the McLeod phenotype. Multiple known genetic variations can lead to the McLeod phenotype, but based on molecular testing, this donor did not appear to have any of them.
Since this discovery, this donor has been able to successfully donate 38 times and further support the American Rare Donor Program. Four donations have been used to support a child with McLeod syndrome and CGD during bone marrow transplant.
Historically, when typing a patient for the RhD antigen, hospitals have been restricted to converting non-binary results into a positive or negative for entry into the electronic health record, or selection of blood products, and determining whether to give Rh immune globulin (RhIG). Since alloimmunization to RhD is clinically significant, both in the context of pregnancy and transfusion, it is critical to manage patients with serologic weak D or RhD typing discrepancies appropriately.
In this article, Margaret Keller, PhD, who is the Executive of the Red Cross National Laboratories and the American Rare Donor Program, summarizes decades of research and laboratory findings and provids a workflow for when a hospital blood bank should consider using RHD genotyping to resolve a serologic weak D type. The approach is designed to precisely identify patients at risk of RhD alloimmunization and provide a financial analysis that may be cost saving, though the greater benefit may arise from better portability of personal health information and/or a national electronic health record.
During Lab Week 2023, we celebrate the efforts of all medical laboratory professionals, but especially those who call the Red Cross home. Their contributions affect patients around the globe. Therefore, this month, we place laboratory services in the spotlight (where they belong) and showcase some of the leading research and advances of the Red Cross.