From the described cord blood scenario, which donor phenotype would be compatible for an exchange transfusion?

From the described cord blood scenario, which donor phenotype would be compatible for an exchange transfusion?

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

Answer: (A)

In exchange transfusion for a newborn, the goal is to replace the baby’s blood with donor red cells that won’t be attacked by maternal antibodies and won’t trigger ABO or Rh incompatibilities. The donor units should match the baby’s ABO type as closely as possible, be Rh negative to avoid exposure to the D antigen, and lack any additional antigens that maternal antibodies could target. In this cord blood scenario, the best donor profile is one that is compatible with the baby’s A blood type, is Rh negative to prevent anti-D reactions, and lacks C and Lea antigens to avoid antibody-mediated hemolysis from maternal antibodies against those antigens. A donor with group A, Rh negative, and negative for C and Lea meets all of those needs, making it the safest choice for reducing risk during the exchange transfusion. The other profiles would either introduce an Rh antigen that could provoke a response, carry antigens (like C or Lea) that maternal antibodies could attack, or otherwise increase the chance of a transfusion reaction.

In exchange transfusion for a newborn, the goal is to replace the baby’s blood with donor red cells that won’t be attacked by maternal antibodies and won’t trigger ABO or Rh incompatibilities. The donor units should match the baby’s ABO type as closely as possible, be Rh negative to avoid exposure to the D antigen, and lack any additional antigens that maternal antibodies could target.

In this cord blood scenario, the best donor profile is one that is compatible with the baby’s A blood type, is Rh negative to prevent anti-D reactions, and lacks C and Lea antigens to avoid antibody-mediated hemolysis from maternal antibodies against those antigens. A donor with group A, Rh negative, and negative for C and Lea meets all of those needs, making it the safest choice for reducing risk during the exchange transfusion.

The other profiles would either introduce an Rh antigen that could provoke a response, carry antigens (like C or Lea) that maternal antibodies could attack, or otherwise increase the chance of a transfusion reaction.