Based on the postpartum and cord blood results, which donor phenotype is indicated for an exchange transfusion?

Based on the postpartum and cord blood results, which donor phenotype is indicated for an exchange transfusion?

• A. Group A, Rh-negative, negative for C and Lea
• B. Group A, Rh-negative, negative for C, I and Lea
• C. Group O, Rh-positive, negative for C and I
• D. Group AB, Rh-negative, negative for D and Lea

Answer: (A)

For a neonatal exchange transfusion, you select donor red cells that will minimize antigen exposure that could trigger a reaction based on the infant’s cord-blood findings. If the cord blood shows the infant is type A and expresses certain antigens such as D (Rh), C, and Lea, you want donor cells that match the ABO type but lack the antigens likely to provoke an antibody-mediated response from maternal antibodies or from the neonate’s own system. Therefore, choosing donor cells that are Group A, Rh-negative (no D antigen), and negative for C and Lea avoids introducing those specific antigens while still matching the infant’s ABO type. This reduces the risk of hemolysis from anti-D, anti-C, or anti-Lea antibodies during and after the exchange.

For a neonatal exchange transfusion, you select donor red cells that will minimize antigen exposure that could trigger a reaction based on the infant’s cord-blood findings. If the cord blood shows the infant is type A and expresses certain antigens such as D (Rh), C, and Lea, you want donor cells that match the ABO type but lack the antigens likely to provoke an antibody-mediated response from maternal antibodies or from the neonate’s own system.

Therefore, choosing donor cells that are Group A, Rh-negative (no D antigen), and negative for C and Lea avoids introducing those specific antigens while still matching the infant’s ABO type. This reduces the risk of hemolysis from anti-D, anti-C, or anti-Lea antibodies during and after the exchange.