FRCPath Haem Part 1 MCQs-Transfusion 500

A 64-year-old woman with myelodysplastic syndrome has received multiple red-cell transfusions over the past 18 months. She is group A, RhD positive, and requires further red-cell transfusion. Her antibody screen is positive, and a complex antibody identification panel is performed.

The laboratory tests untreated and papain-treated reagent red cells. Following papain treatment, some reactions become stronger, whereas others disappear completely. The transfusion laboratory is concerned that enzyme treatment may mask clinically significant alloantibodies.

Which ONE of the following correctly describes the expected effects of papain treatment on red-cell antigens?

A. Rh and Kidd antigens are enhanced, Duffy and MNS antigens are destroyed or markedly weakened, and Kell antigens are generally unaffected.

B. Rh and Kell antigens are enhanced, Kidd antigens are destroyed, and Duffy antigens are unaffected.

C. Rh and Kidd antigens are destroyed, Duffy and MNS antigens are enhanced, and Kell antigens are unaffected.

D. All clinically significant antigens, including Duffy, MNS and Kell, are enhanced by papain treatment.

E. Kell and Duffy antigens are destroyed, while Rh, Kidd and MNS antigens are enhanced.