Jared Rice: When a Negative DAT Doesn’t Mean the Alloimmune Risk Is Gone

Jared Rice, Nurse Professional Development Specialist at Cleveland Clinic, shared a post on LinkedIn:

”A neonate is born after receiving multiple transfusions in utero. Hemoglobin looks reasonable. The DAT comes back negative, and it’s tempting to read that as reassurance that the alloimmune process has resolved.

It hasn’t. At this point, the DAT result can be actively misleading, and reading it the wrong way risks missing an infant who is still at real risk from an antibody that hasn’t gone anywhere.

A similar disconnect shows up with hydrops. Correcting fetal hemoglobin with transfusion doesn’t mean ascites and effusions resolve on the same timeline, because the fluid accumulation traces back to a hepatic mechanism that doesn’t reverse the moment anemia does.

This video works through the full cascade in severe hemolytic disease and erythroblastosis fetalis, from the antibody crossing the placenta to why a corrected hemoglobin and a negative DAT can still leave a critically ill neonate.”

Stay updated with Hemostasis Today.