dcharland

What is your promised Turn around Time for KBs? We have begun accepting KBs from outside hospitals who are demnding a 4hour TAT which is just about impossible especially on night shift.

Thank you all for your posts. What I have seen after transfusing these antibody units, is the passively aquired antibody showing up in the patient's next antibody screen. Now the patient's antibody screen is postive, requiring antibody identification, IgG crossmatches, unit antigen typing etc. etc. This is an additional cost to the patient which I struggle with ethically. How do explain this to the patient and the physician? Not to mention the additional workload for the blood bank?

My supplier wants to provide us with donor units from individuals whose plasma contains unexpected anitbodies. I do not want to accept these units. What are other institutions experience with these types of units?

Presently we make 100cc aliquots (in a bag with 2 syringes attached) in a cooler for many of our NICU babies who go to the OR (mostly G.I. type surgery). We have about 75% wastage on these aliquots. The aliquots are returned from the OR unused and expire within 24hours. To reduce wastage we would like to propose to anesthesia that they take a whole unit of blood that has been irradiated and the blood bank will send chatermed syringes along with the unit. If the baby needs blood, anesthesia can spike the unit and draw the aliquot into the Chatermed syringe. If the unit is not used it can be returned and then used for an adult and thus not wasted. Our dilemma is what about labelling the syringes? We cannot count on anethesia labeling if the unit is spiked and we don't want to label an empty syringe. Anybody out there solved this problem?

We use 5 day plasma for all patients (except hemophiliacs). Factor VIII and Factor V are reduced but are still at suffient levels to help maintain hemostasis. See "Serial measurement of clotting factors in thawed plasma stored for 5 days" Katharine A. Downes in Transfusion Volume 41, issue 4, pages 570-570. Published online 4/21/2002. We are a level 1 trauma center. Good Luck!

Thanks for the info, we keep 2 A's and 2 O's and I don't think that is enough. It's so helpful to see what other places are doing.

Do you have AB plasma thawed in case of a Massive transfusion Porotocl being activated?

Anyone out there have a manual washing procedure for 1/2 apheresis platelet? This comes up rarely but more than once for us... Mom has an anti-PLA1 platelet anitbody and donates a platelet for her baby. We need to wash away that antibody before transfusion. We are concerned volume reduction isn't good enough. We use the COBE for washing whole units of rbcs and platelets normally.

Has anyone had experience transfusing an IgA deficient patient with anti-IgA antibodies >1000U (and anti-c) with RBCs? I understand deglycerolized rbcs are first choice and then second choice is washed (X2) RBCs. Is deglycerolizing really necessary?

I would also like a copy of both audits, we are revising ours too!

When we have weak reactions with Panel A and Panel B without a good answer to what the antibody is, we take an immucor panel and make a .8% diltuions of the cells and run that and typically we will get stronger reactions. We don't send out because the ARC in Baltimore uses tubes.

Thanks Shelly, this is exactly how our neonatologists practice, more concerned with donor exposure...

That would be great if you would share your SOP! My email is debra.charland@inova.org

We have a large cardiac surgery program for both adult and pediatric patients. Currently we use blood <7 days old for our pediatrics that go on bypass during surgery. Once the child is out of surgery we drop the < 7day requirement. Also, children on ecmo get <7day old RBCs always. We do not do this for Adult cardiac patients but I'm sure we'll hear about the article from the surgeons soon!

Presently we assign an infant a unit of RBCs, sterile dock with chatermed syringes and take aliquots off the unit until its used up. Is there anyone out there that has a cutoff date for using these units? 2 weeks, 10 days inorder to give these infants fresher units? I am not advocating fresh <7 days old for all infants but isn't it better to give these premie's blood that isn't at the end of it's life? We have had a couple of premie's recently that had problems with potasiums going up after transfusion and one baby the bili shot up after transfusion.