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OPUS104

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About OPUS104

  • Birthday 07/01/1969

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  • Location
    TN
  • Occupation
    Regional Blood Bank Reference Lab

OPUS104's Achievements

  1. Hey Liz, I often cant get online frequently and just saw your question. My situation is like what Malcolm is talking about.... we are a small ref. lab so our stock of rare cells is not near as impressive as his. We have been questioned a couple of times by our super about making sure the reactions are a pan even though the DAT and Auto are +. For us its a matter of CYA so we dont get second guessed later.
  2. Just a question here Vic. Did your Gel reactions show the typical abnormal appearance often (though not always) seen with "cold antibodies" in Gel. We call them waterfall, though we have hear them call hazy through whole matrix. Just wondering.
  3. I havent been on for some time now, so this may have been stated and I have missed.... We always make sure the original Gel reactions ARE a pan. We run all available high frequency negative cells we have, along with a standard panel. Check trans history, eluate, once satisfied it is a warm-auto we go straight to tube. Usually LISS or unenhanced.
  4. We also have a couple of these sent to us each month. If they call before sending the sample we will remind them to DAT test in Gel before sending. MOST of these are due to + DAT. (at least here they are) Do those of you using Gel for ABO/Rh see many problems due to Gel? As a side thought, it surprises me how many hospitals use Gel and the ORTHO person training them didnt show them how to perform Gel DAT. Had a small hospital send us 3 samples one morning with positive screens. (they usually send us 2 a month) Called them before starting these and found out all three were 1+ on cell one. Told them to do DAT on that cell and guess what.... yep 1+.
  5. When we have antibodies that we can only ID in one media, it doesnt bother me. (even if it doesnt make sense, like something neg. in Gel but 2+ in LISS) What bothers me, is 3 cells reactive out of 45 in PEG and EVERYTHING else is negative. Enzymes, LISS, Gel, 6 Coombs Xmatch all neg. Thats when I worry. My lack of knowledge and exp. (I have only been blood banker for 10 years) keeps me second guessing myself late into the evening sometimes. I notice many of the workups we receive that are only detectable on homozygous cells in Gel, are on older women (to me that is 75 and older) who have history of multiple pregs. I wonder how clinically significant these are when they get transfused on negative crossmatches. At some point I guess we just have to say, "we have done as much (within reason) as we can to make this transfusion safe " and pray HE will take care of the rest.
  6. I think we can all agree that there is not a "catch-all, be-all" method. Having said that, we have seen quite a few samples come in as "just two very weak cells" in tube for us to work-up the next morning. Then when we call to tell them it is a straight-up anti-E that only shows on homozygous cells in Gel.... well thats usually not good when they transfused 3 "crossmatch compatible" units the night before. Do I have post-transfusion info? No. But I think we can all agree these can not be good situations. (I am aware of one fairly serious post-rxn involving a Kell)
  7. This is from a small facility, (so take it for what its worth) we only use different media if the results aren't clear cut. Some people we talk to start with two medias at the beginning, but we have not seen the need if it turns out to be a straight up Kell or E. If we carried it to extreme, we would be doing full panels on every donor/pt instead of just screens. Having said that, it does seem to be an odd workup anymore that doesnt have at LEAST two medias.
  8. Instead of pre-warming, how many ppl use the REST reagent? We basically almost never use pre-warming Terri.
  9. I have seen several answers while reading over the years, but the answer I see most is 16 on 4 regions. Assuming that answer is acceptable, (and I'm not sure it is. LOL) lets stay with the D vibe. We have several donors who are D+ and have an apparent anti-D, I know thats not amazing, but its always fun. (I'm ez to amuse) What other antibody could be mimicking D on my Rh positive patient, and what can I test with to prove it is not there.
  10. This is a pheresis product and requires an actual machine, just like the pher. platelets. As a collection center, I can say that the equipment is expensive, as is each kit needed per donor. (the unit is leuko-reduced during collection) Also, as someone mentioned, there is a whole different set of documentation for donors and a whole different set of daily and monthly controls and QC. Not to mention totally different training for both the phlebs and component ppl.
  11. Well Adiecast, we had a 53 year old female sickle-cell pt with Fy5 that had Rh issues. I remember looking up what Fy5 was because it had been so long since we had even read anything about it.......going to get my book out now (again, sigh) something about null cells?
  12. I vaguely remember its the Gerbich null, but not the antigens. (I only remember that little bit because I recently read something about it) so there is a partial answer. (If its right so far. lol) someone provide the antigens.
  13. We are a small blood center (about 85K draw a year) and were just "dinged" by AABB for not performing QC on our manual nageotte chamber testing. So I guess THEY think it is necessary. We have to have most of our counts within a couple of hours for product release, so send-outs are not an option. We do not do enough of them daily to justify a flow either. I guess we will start with dmorissbb's reagent and see from there.
  14. Same as Malcolm, 2 Homos whenever possible. Which generally it is.
  15. I always enjoy your posts for both content and entertainment Malcolm! As a side question to this thread...... how old of a panel does everyone NORMALLY use?
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