FRCPath Haem Part 1 MCQ-Transfusion 476

A 27-year-old woman of childbearing potential is known to be group O, RhD-negative with a negative antibody screen. She develops a major obstetric haemorrhage following emergency Caesarean section.

Because of an immediate shortage of O RhD-negative red cells, she receives 6 units of O RhD-positive red cells as part of the major haemorrhage protocol. Once stabilised, the transfusion laboratory considers a red cell exchange procedure to reduce the volume of transfused RhD-positive red cells and prevent RhD alloimmunisation.

Following 1–2 volume red cell exchange, what is the most appropriate step ?

A. Repeat ABO and RhD typing using the indirect antiglobulin technique

B. Kleihauer–Betke test

C. Flow cytometry using an appropriate anti-D reagent

D. Direct antiglobulin test (DAT)

E. Maternal serum antibody screen for Anti-D F. No action required