NatishaDixon

Our protocol for patients with antibodies directed against low incidence antigens is if the antibody is detectable, we use the patient's plasma/serum to screen for the antibody during the crossmatch. If the antibody is no longer detectable, we have the units screened for the antigen or use units historically negative for the low incidence antigen. Sending a unit all the way to a reference lab and having it sent back for a low incidence seems absurd. Wouldn't the segments just suffice? We occasionally do antigen typing on segments and we verify the donation numbers and corresponding segment numbers.

I work for United Blood Services and we use Progesa. We're currently working to launch web-based eProgesa in the next few years. I've only worked with that program so I'm not sure how it compares to others.

I am curious if anyone else performs a post sampling yield. When we have an initial platelet yield between 2.5 and 3.2, we recalculate the platelet yield using the new volume after the sample for the initial platelet concentration and bacterial detection (and sometimes monthly QC) have been used. We have a few 3.2 X 10^11 platelets that end up being 2.9 X 10^11 low yield platelets based on the actual volume of the platelet prior to distribution. We utilize platelets with yields between 2.5 and 2.9 and label them an E4643V00 affixed with tie tag stating the yield. We discard anything with yields less than 2.5 unless a physician specifically requests it. We come so close to the 10% allowable volume variation that we perform recalculations for all platelets within the aforementioned range. Does anyone else do this?

We mix PEG with LISS and put it in Gel in hopes of detecting every antibody... just kidding.

We monitor the device for 24 hours. We are also a blood bank with a lot of product so that might be why we err on the side of caution.

I work at a Blood Bank and our CLIA Medical Director is off-site. We separate SOP updates by department so Collections handles donor eligibility/collection and my Laboratory handles their own updates which includes component manufacturing, center testing, transfusion services, and immunohematology reference testing. Luckily for me, our Corporate Office pre-selects which SOPs involve medical and technical policies, processes, and procedures. I can try to outline our process in hopes that it can offer some sort of help. Prior to implementation of any new SOP or any update, CO sends it to our document control contacts so we can train staff on the policies and so we can get CLIA Medical Director approval. Typically, we get updates at least two weeks prior to implementation so we aren't frantically running around trying to get approval and staff members trained. Sometimes we aren't that fortunate but oh well . For any new/updated SOP that involves a CLIA regulated task, we print these for our CLIA Medical Director to review; this includes SOPs involving platelet selection, donor eligibility, irradiating, etc. Even if just a typo was corrected, for example changing "is" to "are," we have our CLIA Medical Director approve the SOPs if it involves a CLIA regulated task. At the end of each SOP, we define which alteration was made for each revision of an SOP. This provides a quick guide so a person reading the SOP can know what change to look for. We also have a highlighting for each SOP revision which makes added or changed text more apparent. I find this helpful because searching for the change can be akin to searching for Waldo. This makes it easier for our Medical Director so he's aware if there was a serious change or just a corrected typo. We have a form where we list each SOP that requires approval at that time and our CLIA Medical Director will sign that after he approves the SOPs.

For our reference samples, we perform a 3 cell screen with an auto control using both LISS and PEG initially for all new patients. If we have negative results with those media, we then use Gel. If necessary, we perform a screen using ficin treated red cells to try to replicate results of the submitting facility. We have seen antibodies demonstrated in Echo that were not detected by PEG method but that is why we include enzyme treatment and Gel testing if a submitting facility has suspicions.