Interpretation Builder

Generate professional clinical interpretations for blood bank workups with automatic compatibility calculations.

Interpretation Builder

Case Setup

WOCBP / HDFN applies

Special scenario

Load example antibodies

Examples fill sample inputs for training or a fast starting point. Review and adjust before copying.

Paste antibodies or workup text

Antibody Findings

Antibodies Identified

Type and select antigens, or use quick-add buttons below

Quick Add - Common Antibodies:

Cold-reactive antibody detected

Is this patient scheduled for a procedure associated with systemic hypothermia or cold cardioplegia (e.g., cardiac surgery on cardiopulmonary bypass, or aortic/arch repair with deep hypothermic circulatory arrest)? If so, check the box below — cold-reactive alloantibodies require antigen-negative units regardless of prewarm results, and the cold-agglutinin guidance is expanded for perioperative coordination.

Planned hypothermic / cold cardioplegia surgery

Include Previously Identified Antibodies

Enable to designate which antibodies were previously identified. Click on an antibody tag to toggle its status.

Blue tags = Newly identified | Gray dashed tags = Previously identified | Click to hide significance text | Click OSH to flag an antibody as reported by an outside facility

Click any antibody tag above to toggle between new and previously identified

Outside-facility cold antibodies — manage as clinically significant

When checked, the antibody is treated as potentially warm-reactive (warm reactivity not excluded at the outside facility) and requires antigen-negative units. When unchecked, standard graduated handling applies (antigen-negative only if AHG crossmatch-compatibility cannot be achieved, unless it is tested and does not prewarm away).

Prewarm Testing Result

Record the 37°C settled prewarm result for each cold specificity independently. PREW = non-reactive at 37°C and AHG; NPREW = reactive at 37°C and/or AHG.

Warm Autoantibody Auto?

Mode

Panreactive (full workup)

Auto with specificity

Provenance

Current workup

Previously identified (in-house)

Identified at outside facility

Include significance note

Autoantibody Specificity

Which antigen(s) does the warm autoantibody show specificity for? Select one or more.

Molecular Reference Lab (for cognate antigen confirmation)

Leave blank to omit the molecular-confirmation paragraph.

DAT Result

IgG+/C3−

IgG+/C3+

IgG−/C3+

IgG−/C3−

Neg polyspecific

Show strength

IgG: C3:

Eluate

Not performed

Panreactivity

Nonreactive

Specific Ab(s)

Eluate specificity:

Specificity Details

Autocontrol

Gel:

PeG-AHG:

LISS:

Dropdowns auto-generate text below. You can edit the text freely.

Phenotyping & reference-lab

Serologic workup referral ?

Blood Bank (original testing)

Reference Lab

Molecular analysis referral ?

Molecular reference lab

Serologic phenotype statement ?

Transfusion History

Workup Details

Hospital Blood Bank

Include IRL referral paragraph

Reference Lab

Adsorption

Adsorption Type

Differential warm allo-adsorption

Autologous adsorption

Cycles:

Adsorption Result

No underlying alloantibodies

Alloantibodies found

Select alloantibodies found:

Include WAIHA clinical correlation

Include transfusion recommendation

Passive Anti-D from RhIg

Use when anti-D is detected and attributable to RhIg administration. Add any previously-identified coexisting antibodies (e.g., anti-Le^a) in the Antibody Findings section above and mark them as previously identified — they will appear in the header and drive the fallback-antigen transfusion clause.

Tip: If this patient is pregnant, set Patient Context → Pregnant above. The interpretation will then include the "this patient is pregnant and…" framing in the history sentence.

Provenance

Current workup

Previously identified (in-house)

Identified at outside facility

Include significance note

RhIg administration date

Pre-RhIg antibody screen date (optional)

Leave blank if no pre-RhIg screen is on record. A gap >14 days triggers the ambiguous-passive variant (with 6-month repeat-testing guidance).

Pre-RhIg screen result

Negative

Positive

Enter a screen date above to specify result.

The positive antibodies / nonspecific reactivity will be pulled from Antibody Findings → Previously Identified above.

Select at least one antibody or non-specific reactivity. Mark antibodies as previously identified in the Antibody Findings section, or check "Previously identified nonspecific reactivity" in Output Options below.

⚠ Anti-D was present on the pre-RhIg screen. This is not consistent with today's anti-D being newly passive from the current dose. Two possibilities:

Prior RhIg administration (persistent passive) — check the box below and enter the prior RhIg date if known.
Active alloimmunization — uncheck "Patient remains a candidate for RhIg" above and work up accordingly.

Prior RhIg administration accounts for the pre-screen anti-D

Prior RhIg date (optional)

EMR source

Patient remains a candidate for RhIg

Uncheck only if the patient has been confirmed as having immune anti-D (per ACOG PB 181).

Alloantibody + Genotyping (recent transfusion)

Use when an alloantibody is identified but the patient was recently transfused (within 3 months per SOP), producing a DAT+/autocontrol+ pattern that could be confused with warm auto. Reference-lab genotyping predicts the patient's true cognate-antigen status.

Genotyping target antibody (workup rationale)

Suggestions are drawn from newly-identified antibodies above. Type and press Enter to pick the first match.

DAT result

IgG+ / C3−

IgG+ / C3+

IgG− / C3+

IgG− / C3−

Polyspecific− (no reflex)

Autocontrol

in testing

Use free-text override

Eluate result

Negative

Panreactive

Specific

Not performed

Omit (no sentence)

Eluate specificity:

Eluate not performed: DAT is IgG-negative (eluate recovers RBC-bound IgG, so no elution is possible). The eluate sentence is suppressed regardless of selection.

Patient was recently transfused

Pre-transfusion DAT available

When pre-transfusion DAT is unavailable, the interpretation will emit "Pre-transfusion DAT unavailable."

⚠ Verify recent-transfusion timing. DSTR/DTR statement asserts patient was transfused within the prior 28 days. Confirm against the chart before finalizing.

Reference laboratory

Predicted phenotype

Pick from the dropdown or choose "Custom..." for free-text entry.

Scanned-docs label

Cold Antibody / Autoantibody (unspecified)

Use when the lab detects reactivity at cold phases without identifying a specific antibody. The output label is derived automatically: "cold autoantibody" if autocontrol or DAT-C3 is positive, otherwise "cold antibody."

Phase(s) of reactivity:

Immediate spin

Room temperature

4°C

Additional findings:

Positive autocontrol

Positive DAT for C3 (reported by warm-auto DAT)

Provenance

Current workup

Previously identified (in-house)

Identified at outside facility

Include significance note

Drug Interference

Use when the patient is on a therapeutic monoclonal antibody known to interfere with pretransfusion testing. Replaces the standard transfusion paragraph with drug-specific guidance.

Drug class:

Provenance

Current workup

Previously identified (in-house)

Identified at outside facility

Include significance note

Workup state

Pre-therapy

On-therapy

Drug examples (free text)

Order code

Reference Lab

Direct antiglobulin test (DAT)

Polyspecific−

IgG−/C3−

IgG+/C3−

IgG+/C3+

IgG−/C3+

Patient had recent RBC transfusion

IRL DAT result

Polyspecific−

IgG−/C3−

IgG+/C3−

IgG+/C3+

IgG−/C3+

Adsorption result

No alloantibodies

Alloantibodies found

Adsorption result derived from selected antibodies (anti-CD38 ABID r/o is performed at the IRL).

K antigen typing

Negative

Positive

Unknown / pending / unable to type

Workup state

Pre-therapy

On-therapy

Drug examples (free text)

Order code (auto-fills with mode)

Reference Lab

Prior / Outside-Facility History

Quick history entry

Document a bolus of previously-identified or outside-facility findings — they fold onto the header lines without a full per-finding workup. Enter alloantibodies in Antibody Findings (mark them previously identified / OSH); nonspecific reactivity uses Output Options.

Warm autoantibody

Cold autoantibody

Passive anti-D (RhIg)

Anti-CD38 interference

Anti-CD47 interference

Include significance notes

Off = header line only. On = append each finding's clinical-significance note.

Patient Context

Non-pregnant

Pregnant

Sickle Cell/Hemoglobinopathy

Neonate

Neonatal workup with eluate findings + maternal correlation. DAT result applies to the neonatal sample; the Antibodies Identified list above represents the eluate specificities.

Neonatal DAT

IgG only

C3 only

IgG + C3

Negative

Add at least one antibody above to populate maternal/neonate fields.

Account for each pregnancy-relevant antibody:

Sensitive-method-only reactivity is reported as a titer of no greater than 1 by local SOP. Critical threshold is generally 16, except anti-K where 4 is often used.

Include paternal testing paragraph

Select antibodies to include in paternal testing:

Anti-M reactive at 37°C (IgG)

Check if anti-M reacts at body temperature. IgG anti-M requires titer monitoring; IgM anti-M does not.

Include anti-G evaluation paragraph

When D and C are both present, anti-G may be masquerading as anti-D+anti-C. The distinction matters because patients with anti-G still need RhIG, while patients with true anti-D do not.

Patient Antigen-Negative Phenotype (for extended matching)

Select antigens the patient is negative for. This helps generate more specific matching guidance.

Consider Autoantibody?

is identified but the patient is not -negative. In SCD patients, this may indicate an autoantibody with specificity due to variant alleles.

Include hypothermia/cold cardioplegia warning

Include Transfusion Recommendation (handled by drug-specific transfusion paragraph)

Auto-calculate from Compatibility Calculator

Automatically includes donor compatibility statistics based on selected antibodies

Prophylactic Antigen Avoidance

Cannot Rule Out Other Antibodies

Based on the identified antibodies, some additional antibodies cannot be definitively ruled out with standard panels due to haplotype linkage or shared epitopes.

Apply prophylactic antigen avoidance

Include selected antigens in transfusion recommendation. Use this checkbox to select or deselect all.

General Practice: When an antibody cannot be definitively ruled out due to haplotype linkage, many institutions recommend prophylactically avoiding the linked antigen, especially if:

The patient phenotypes negative for the linked antigen
The patient is in a high-risk category (e.g., chronically transfused, women of childbearing potential)
Rare cells for confirmation are not readily available

Important: Always follow your local SOP and consult with your medical director when needed. Consider sending specimens to a reference lab for adsorption studies or RH genotyping if definitive identification is required.

CHECKLIST FOR INTERPRETATION WRITER

Reviewed local SOP for prophylactic avoidance Checked patient phenotype for linked antigen(s) Considered patient's clinical status and transfusion history Documented rationale if prophylactic avoidance not applied

Advanced Output Options

These mirror the quick overrides beside the generated interpretation.

Include rule-out statement ?

Include HDFN statement ? (typically relevant for women of childbearing potential)

Nonspecific reactivity ?

None

Current — newly identified

Previously identified (in-house)

Reported by outside facility (OSH)

Include significance note ?

Include rouleaux statement ?

Append references in interpretation ?

Nonspecific reactivity observed in (optional):

AHG phase (LISS) Gel Solid phase

Rouleaux — LISS phases affected:

IS RT 37°C

Delayed transfusion reaction statement ?

⚠️ Verify recent-transfusion timing This paragraph asserts the patient was transfused within the prior 28 days. Confirm against the chart before finalizing the interpretation.

Include IVIg passive antibody statement ?

Include expected duration of interference

DAT pattern (e.g., "positive for IgG, negative for C3d"):

Eluate findings (e.g., "identified anti-A antibodies"):

Include ABO isohemagglutinin source attribution

Antibody detected:

Detected in:

No current or known history of ABO discrepancy

No known history of recent transfusion with plasma-containing products

Generated Interpretation

Patient Context

Non-pregnant

Pregnant

Sickle Cell

Neonate

Include paternal testing

Anti-M reactive at 37°C (IgG)

Include anti-G evaluation

Include hypothermia warning

Output Options

Include rule-out statement

Include HDFN statement

Nonspecific reactivity

None

Current

Prev. ID (in-house)

Outside facility (OSH)

Include significance note

Include rouleaux statement

Append references in text

Nonspecific reactivity observed in (optional):

AHG phase (LISS) Gel Solid phase

Rouleaux — LISS phases affected:

IS RT 37°C

DTR statement

Include IVIg passive antibody

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Compatibility Calculation

Compatible Donors

therapeutic / cognate antigen-negative

Units to Screen

Rarity

Fully Matched

cognate + prophylactic

Units to Screen

Rarity

Notes

Clinical Guidance

Each interpretation element is shown below with the options/logic that determined its content.

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