POLICY TITLE: Antigen Typing of Red Cells

DISTRIBUTION: Laboratory, Blood Bank PAGE: 1 of 3

EFFECTIVE DATE: 2/17/15 NEXT REVIEW DATE: 8-31-23

REPLACES POLICY DATED: 9/18/19

AUTHOR/OWNER: Barbara Swanson, CLS APPROVED BY: Rebecca Sonu, MD

SCOPE: Clinical Laboratory Scientists

POLICY STATEMENT: This procedure provides instructions for donor unit antigen typing and patient
antigen typing.

PRINCIPLES OF THE PROCEDURE: Antigen typing of red blood cells is done on donor blood in order to
provide antigen negative blood for patients with the corresponding antibody. It also must be done on patients
when an antibody is first identified, to show that they are negative for the corresponding antigen.

QUALITY CONTROL:
1. Run a known negative and a known positive control each day of testing.
2. For the positive control run a cell heterozygous for the antigen you are testing, if available.
a. Note: Heterozygous means that the cell is positive for both antigens of a pair such as Fya and
Fyb.
3. Use cells from an in-date screening cell set or antibody identification panel cell.
4. Use 0.8% screening cells or panel cells for gel testing. Perform a negative control and a positive
(heterozygous) control on each run.

PROCEDURE:
Tube Testing:
1. Prepare a 3% to 5% suspension of red blood cells in isotonic saline.
2. For positive and negative controls use 3% cells from Immucor panel.
3. Label tubes for units to be tested and a positive and a negative control.
4. Follow the package insert for each of the antigen typings.

REPORTING RESULTS IN WellSky:

Component Antigen Testing
1. Add the antigen typing in WellSky by going to Inventory and on the top right section called
Active Inventory. Click the top corner arrow in the “Active Inventory” screen to make it larger.
Click “MMC”.
2. Highlight the unit and click AAA. Enter the antigen for the donor unit.
Patient Antigen Testing
 1. The antigen typing on a patient is added by going to the Patient Module in WellSky. Highlight
the patient and click “antigen”. Add and save each antigen typing
2. The antigen typing is charged manually.
QC Documentation for manual antigen testing of Patients and Units
1. Record on the “Antigen Screening Worksheet”. BB Form.020
a. Record lot numbers for antisera and control cells
b. Record donor unit and patient results

TAGGING UNITS:
1. Stamp a blank tie tag with the antigen screening stamp on 1 side
2. Fill in unit number or use a unit number sticker, and write “Neg” or “Pos” for appropriate antigen(s).
3. Use the “Other” section for Fya, Fyb, Jka, Jkb, S and s.
4. Enter date and initials.
5. Attach to unit.
6. If Vitalant sends us units for which the antigens have not been confirmed, we must confirm them here
before issue. You can either write the confirmation on Vitalant’s tag (if the unit is being transfused for
sure) or you can attach one of our tags in addition to the Vitalant tag.

ANTIGEN FREQUENCIES:
Antigen Rh Positive Rh Negative
K Whites 91% negative
Blacks 98% negative
E 50-70% negative 95% negative Test one more unit than you need

C 20% negative 95% negative Test one more unit than you need

Little c 20% negative Almost 100% Order screened units

positive
Little e 3% negative Almost 100% Order screened units
positive
Fya White 32% negative Test 3 to get one unit
Blacks 67% negative (Fya-Fyb-)
20% negative (Fya-Fyb+)
Asian 4% negative (Fya-Fyb+)
Fyb White 20% negative (Fya+Fyb-) Test 4 to get one units, if time allows,
Black 22% negative (Fya+Fyb-) order screened units
67% negative (Fya-Fyb-)
Jka White 24% negative (Jka-Jkb+) Test 4 to get one units, if time allows,
Blacks 8% negative (Jka-Jkb+) order screened units
Asians 27% negative (Jka-Jkb+)

Antigen Typing of Red Cells

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 Jkb White 26% negative (Jka+Jkb-) Test 4 to get one units, if time allows,
Blacks 52% negative (Jka+Jkb-) order screened units
Asians 23% negative (Jka+Jkb-)
S White 48% negative (S-s+) Test twice as many units as you need
Blacks 69% negative (S-s+)
2% negative (S-s-)
s Whites and Blacks 3% negative Order screened units

CALCULATION OF NUMBER OF UNITS TO TYPE:

Formula for calculating the number of units which will be antigen negative in 100 donors:
Negative antigen frequency x negative antigen frequency x 100= number of units negative

For example to find five donor units that are Jka negative and Fya negative:
Jka is 24% and Fya is 34%.
0.24(24%) x 0.34 (34%)= 0.0816 or 8% or 8 out of 100 donor units will be negative for Jka and Fya
1 out of 12
To find 5 units = 12 x 5 = 60 units. So you should order screened units

Note: Except in urgent situations do not screen units for Fya,Fyb, Jka, Jkb or s. It is better to order
screened units from Vitalant. Screening for S and Fya is reasonable unless the patient has other antibodies
which would make it difficult to find that combination..

REFERENCES:
Harmening, Denise M. Modern Blood Banking and Transfusion Practices, 4th Edition 1999, pg. 131, 178, 183,
186, 193
AABB Technical Manual, current edition
WellSky Computer Manual
Package inserts:

REVIEWED BY: Barbara Swanson

APPROVED BY: Rebecca Sonu, MD, Joe Jacobs, Barbara Swanson

Antigen Typing of Red Cells

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