What action should be taken next for a patient with a positive antibody screen and history of recent transfusion?

In the scenario of a patient with a positive antibody screen and a recent transfusion history, the appropriate next step is to perform an alloadsorption. This procedure involves using donor red blood cells to adsorb the antibodies present in the patient's serum. It helps in the identification of specific antibodies that may be responsible for the positive screen.

Traditionally, the patient has been exposed to transfused blood, which may lead to the formation of new antibodies. An alloadsorption would assist in distinguishing between naturally occurring antibodies and those that resulted from recent transfusions. This method is particularly useful when determining the specificity of antibodies and guiding future transfusions to prevent hemolytic reactions.

Other methods, such as autoadsorption, would utilize the patient’s own red blood cells to absorb antibodies, which might not be as effective due to the presence of transfusion-related antibodies. Performing a direct antiglobulin test (DAT) might be informative but would not specifically address the need to identify antibodies in the context of a recent transfusion. Issuing O-negative cells may not provide tailored solutions to the potential existence of specific antibodies and could lead to complications if not correctly identified.

Thus, employing alloadsorption is essential for accurately identifying the antibodies present and