False-positive results with chemically modified anti-D do not indicate a need to use a separate, immunologically...

Thirteen of 1450 (0.9%) Rh-negative samples submitted for pretransfusion or prenatal testing gave weak false-positive reactions in immediate-spin (IS) tests with chemically modified anti-D (CM-D). Only seven reacted in control tests with anti-A and/or -B. The other six samples could have been considered Rh positive; however, such a conclusion is inappropriate, since stronger (greater than or equal to 3+) reactions are expected in IS tests with CM-D and the vast majority of true Rh-positive blood samples. Moreover, three of the six false-positive CM-D reactions associated with negative control tests were from patients previously found to be Rh negative. The other three samples gave 1+ to 2+ reactions with CM-D and did not react with anti-A and/or -B; these erroneous CM-D reactions were recognized by confirmatory tests with high-protein anti-D and Rh control reagents that were performed because previous typing results were not on file. Such confirmation, as well as careful grading and proper interpretation of serologic reactions, serves to prevent erroneous Rh typing without the use of a separate, immunologically inert Rh control reagent.