How do institutions report the findings of antibody identification panels for patients who have received Rh Immune Globulin?

A colleague reports that they would like updated information regarding how other institutions report the findings of antibody identification panels for patients who have received Rh Immune Globulin and how have a positive antibody screen, and only anti-D appears to be present by an antibody identification workup. The inquiring colleague wants to know if it would be acceptable to sign out the work up as "all clinically significant antibodies ruled out", or should they report that they have detected only "Rhig D"?

Editors' Note: The following previous discussions are germane to the above question:

• How much pretransfusion testing should be done for a patient with anti-D, acquired by having received an injection of RhIG?
• Indications to perform a titer when anti-D is detected in a patient who has received Rh Immune Globulin
• Does a history of transient passively acquired anti-D from receipt of RhIG disqualify a patient for an electronic crossmatch?

The following comments have been received in response.

ADDENDA Sept. 1, 2010

1. A colleague comments that she does not believe that the presence of passively acquired anti-D (following RhIg administration) should be reported as "no clinically signifigant antibodies are present". Anti-D from administered RhIg could definitely react with Rh Positive red cells. Commenting that anti-D, probably due to RhIg is present with no OTHER clinically significant antibodies would be more indicative of the true picture. Some institutions might want to manage such a patient with an immediate spin crossmatch with D-Negative blood. However, such an approach may not be compliant with current regulatory and accreditation requirements, and there may be a problem with handling those patients differently from all the others. Rather, a crossmatch through AHG would keep all patients with detectable anti-D handled alike.

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