In Focus
Case studies in immunohaematology
Test your knowledge with common, intriguing or complex cases
The Working Party on Immunohaematology strives to promote best practices and engage ISBT members by supporting education in red cell serology, molecular testing, antigen/allele matching to lead to recommendations for compatible transfusion.
It was envisioned by the Working Party Group of 10, who were charged with and initially worked on creating the Working Party for Immunohaematology Aims, Goals and Terms of Reference in 2014, that having Case Studies in Immunohaematology would assist in interested ISBT members learning how the available and new methods for serologic and molecular investigations could be used to solve the most challenging cases presenting with positive red cell antibody screens. These postings of case studies in an easily accessed format were a new concept for ISBT, who embraced the activity and created a site of these to be located on the Working Party site.
The Working Party created a slide, which was approved by ISBT, with recommended topic areas to include, which helped to provide a systematic and logical approach to each case. It was hoped that using a templated slide set would make the case studies easier to follow, understand, and review and would enhance the learning experience. The process is for the author to submit their case study to the Past Chair of the Working Party, who with the Working Party Chair and Vice Chair, review the case. This helps to ensure the testing protocols are sound, the terminology and references are current, and that the author agrees with any suggested enhancements.
The ISBT webpage with the Case Studies in Immunohaematology has been exceedingly popular. Individually, of the top twenty most visited case studies (with 250 or more visits each) there are six with 300 or more visits, five with over 400, one with over 500 and two with over 1000 visits.
To date, the number one visited Case Study, with over 1200 visits was a 2023 case study that highlighted the new KN system antigen, authored by Erwin Scharberg. This new Knops antigen, KDAS (KN10) was recognised by the ISBT in June 2019 at the International ISBT Congress in Basel, Switzerland, and is antithetical to KCAM (KN09). The other case study, with over 1000 visits, involved an anti-Tca, authored by Lilian Castilho. Considering the total views from 2022 to June 2024 of the Working Party on Immunohaematology web resource postings, 10 of the top 20 visited postings were the case studies.
One of the Case studies, authored by Sandra Nance was the basis for the creation of an eLearning module with the assistance of Lilian Castilho and the ISBT Central Office: “Case study: Anti-D + C. Or is it anti-G?” Additionally, the Working Party was approached by one national facility for permission to use the case studies in their education course program schedule for their incoming laboratory professionals.
The case studies page on the ISBT website
Currently, there are 41 case studies published on the ISBT Working Party for Immunohaematology webpage posted from 2016 to 2023, which can be accessed by ISBT members and nonmembers. There are an additional six case studies in the process of review. Twenty nine of the 41 members of the working party (in 2023) contributed these cases.
Contributing case studies fulfills a requirement of the Working Party to contribute to the activities of the Working Party. Remarkably, six members of the WP have submitted three cases each (Sofia Lejon Crottet, Edmond Lee, Ankit Mathur, Cinzia Paccapelo, Mirela Raos, Erwin Scharberg). Six members have submitted 2 cases each. This shows the commitment of the WP members volunteering to creating education events for those technical professionals interested in immunohaematology.
The published cases have included antibodies to high prevalence antigens (19), unusual case presentations (6), combinations of antibodies (5), autospecificities (3), discrepancies in testing (3), therapeutic interference (1), antibody to low prevalence antigen (1), drug induced antibody (1) and others. Some of the case studies topics have included antibodies to high prevalence antigens that are rare, but somewhat more common ( anti-k, anti-Vel, anti-Jk3) and those that are more rarely encountered (anti-Ku, anti-Co3, anti-Sc3).
Example of a case study from the ISBT website
We recognised that it was ambitious to have 12 cases per year as in the first two years, and in the past few years have not realised that number. The plan for the next few years is to post 2-4 case studies authored by the Working Party members per year. Working Party members volunteered at the Working Party meeting in Barcelona to author all planned cases for 2024 and 2025.
Case Studies are a popular format for small and large group meetings. Other ISBT Working Parties have also started using Case Studies for educational purposes. They give the opportunity for all people involved in immunohaematology to study and discuss cases that might be very infrequent or might never be seen in a single institution and to add to the experiential learning needed to solve complex cases. It is hoped that these will also increase the number of elite laboratory professionals who can solve extraordinarily complex cases. Authoring a case study also gives an opportunity for the ISBT Working Party members to share their knowledge, enhance their presentation skills and perhaps add to their resumes.
The Case Studies have covered some of the most common, the most intriguing, the most complex, and the most current topics using state-of-the-art tools. The Case Studies include the current ISBT Terminology in the year submitted and pertinent references so that the members accessing the case can continue to learn more details about the topic or the blood group antigen or system.
