The Medical Director of a blood donor center in the West notes that in the last year, the Director’s facility reference laboratory has seen an increased number of young donors (<19 years of age) with positive direct antiglobulin tests. The total numbers are still very small in proportion to the total donor draw at the facility, but in the past they usually saw no more than 1-2 of these cases per month. As the blood center does not release units with a positive DAT for transfusion, these donations are discarded and a letter sent advising the donor of the test results and asking them to refrain from donating.
Does anyone have any ideas or theories as to why a young, apparently healthy person would have a positive DAT? Are these really clinically insignificant in this population? It is difficult to advise these donors as to the significance of these results, given that we do not know of clear associations with future disease such as autoimmune disorders.
The Editors refer readers to a CBBS e-Net Forum discussion from 2003 that is still pertinent: Managing a healthy blood donor who has a positive direct antiglobulin test (DAT)
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Ira A. Shulman, MD
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