Juliane

we don't use isbt yet, so our system has a code for reconstituted whole blood and we have manual hand made labels for that.

We tend to have any discrepancy in Rh type be resolved with supervisory involvement. Read your package inserts, some say partial D is detected, some don't. I was told by a vendor that if it DOES detect a variant like DVI, then they have to disclose it. If not, they don't have to mention it. That is confusing, because we are left to ASSUME.... Also, we confirm the type with two separate venipunctures in these cases before giving type specific (including RH). We add a comment to attempt to explain this to physicians, that the Rh typing is very weak and in some cases, we go on to recommend receiving Rh negative blood (child bearing age females) but to understand that these patients are considered Rh positive as blood donors. We are also considering sending letters to these patients to make them aware that at some facilities they may be considered Rh neg, and at others, Rh pos so they can be aware of this chance in differing blood types being reported. Do any of you participate with the National Patient Antibody Registry? Subscribers data is there to share their histories. It is small but trying to expand. Based out of New Jersey I think now. Curious how this will impact that dilemma of differing Rh types.....

Our facility does not have the resources to do the plasma removal. So we just add AB plasma and do not remove CPDA plasma.

Contact Ortho for USA MTS Gel products, and they will tell you refrigeration is the preferred storage for their gel cards, as the storage range is 2-25'C. So it is perfectly acceptable to be stored at 2-8'C, actually is is better to do so....

I have had some experiences with false positives due to age of reagents (near expiration) getting caught in the gel but not necessarily part of the reactivity. Also, are you storing cards at room temp? the preferred storage is refrigerated, but only if you have the room. If you do I highly recommend changing your storage to refrigerated and it will certainly prevent having to respin them before use, and keep the cards from drying or intra-well evaporation. I would call ortho. are you using a ProVue? Or just Manual.... We have not had this problem with our weak D (2-3+) pos control.

We have evaluated, correlated and validated the Immucor and Ortho Fetal screen kits. The Immucor Kit is overly strong for the positive control, usually finding all the rosettes you need in one field. Whereas the Ortho kit pos control has been equivalently representative of a small bleed in a patient, and therefore more realistic for comparison. We have had several false positive results with the Immucor kit, going so far as to being part of the 17% of participants that had falsely reported a Proficiency sample as being positive, when the intended result was negative for one of the two analytes on a Proficiency from API (due to the poorly performing Immucor kit). Immucor blamed the saline used for the "false positives," stating we needed to use PHIX buffer to correct "our" problem. However, the package insert makes no mention of the PHIX buffer, and that is a shady suggestion at best in my opinion to cover their bad product. I am switching to the Ortho Kit that has validated absolutely perfectly. If you are having trouble with the Ortho kit, perhaps your centrifuge calibration is not what it needs to be because we have been using it with a 15second spin and it is working just fine for us. The G-force matters rather than the RPM. The real positives were positive, and the real negatives were negative with the Ortho kit. Staff even commented how much better they like the Ortho kit, citing it was more realistic to the patient testing.

Thanks. We opted to go ahead with a blood culture type arm prep prior to collection of blood for WBC or RBC tagging and reinfusion. We also thought, that since many times they remain at room temperature for transport and processing that it was prudent to do so.

Nuclear Reinfusions fall under regulatory oversight by the Transfusion Medical Director. They involve collection of a blood sample, processing that sample to tag the Red Blood Cells or WBC with radioactive isotopes and then they are reinfused and the patient undergoes a radiology type procedure. Does anyone collect these products with a blood culture arm prep scrub with an iodine type solution or do you just perform a normal phlebotomy like for regular specimen blood draws with an alcohol arm scrub? My Medical Director has questioned that since these products can be out at room temp for up to 6 hours, that we should be using a blood culture collection type arm scrub to better prevent possible skin contaminants into the sample that will be tagged and reinfused later to the patient. I am trying to gain a consensus on this topic. Thanks! Feel free to email me at julianebreh@lacny.com