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  2. You are quite correct in asking, "what if the original titre was performed incorrectly?", but you have to draw the line somewhere. If you are performing the titre of an anti-Jka, you would (I hope) use a red cell sample that types as Jk(a+b+)? From the text books, you would assume that the red cells express 7, 000 Jka antigens per red cell (given that there are, on average 14, 000 Kidd antigen sites per red cell), but, this is an estimation in itself, and is also the average of the various experiments performed to find out the number of Kidd antigens per red cell. It follows that, unless you use exactly the same source of red cells each time you are performing the anti-Jka titration, you cannot guarantee that the titre of the QC will be within one dilution of the previous result. The same applies for, for example, ABO titres, where the number of antigen sites differs from one individual to another, but also from the age of the various individuals. The adult A1 red cell has between 810 000 and 1 170 000 antigen sites per red cell. The red cells of a new-born will only carry between 250 000 and 370 000 copies of the A1 antigen. Now, I am not suggesting for a single minute that you would use the red cells of a new-born, but there is still quite a difference between an adult with just over 800, 000 A1 sites per red cell, and almost 1, 200, 000 sites per red cell. As long as such a situation is an unusual occurrence, and not a regular occurrence, I wouldn't worry.
  3. Today
  4. We are considering changing the way we "QC" a titer. What we currently do is perform a titer, then freeze an aliquot of the plasma. The next time we titer that patient, we thaw the original titer and perform it in parallel with the new titer. The prior titer and the retested prior titer must agree within one dilution of each other. What if the first titer was not done correctly, then the repeat should not match? We are considering titering a donor who tests positive, maybe have a panel of people titer it to determines its result, then freeze small aliquots of that to be used as a control. What are others doing?
  5. Yes John, I was definitely talking about a mass casualty situation.
  6. Just curious but are you referring to a single patient massive transfusion or a mass casualty situation? I would classify Malcom's examples as mass casualty while a single patient massive transfusion could be the result of any number of things. Then there is everything in between. In the two facilities (both approximately 350 beds) I supervised I left it up to the staff involved to decide what and when they needed help. When help was required I was usually the first one called. Even got a call while fishing in Alaska once. Wasn't much help with that one.
  7. Hello All, Is there any CAP/AABB standard that approves the use of mini panel for positive screens for Anti-D due to Rhogam administration. We currently perform a full panel & rule outs for Rhogam like any other clinically significant antibody. I would like to implement the change to selected panel but, would need a valid justification for my medical director. Thanks for your time & input.
  8. Yesterday
  9. See this large study https://www.ncbi.nlm.nih.gov/pubmed/3137672 regarding use of rh positive blood for untyped trauma recipients. Abstract The emergency blood needs of 449 patients were met by supplying 1,717 uncrossmatched units of either red blood cells (RBC) type specific Whole Blood or group O RBC. The RBC were all Rh positive, and 601 units were transfused to 262 untyped patients. None of the patients presented with anti-Rh antibodies. Only 20 patients who were Rh negative received group O Rh positive RBC, and most of these patients were male. There were no acute hemolytic reactions or sensitizations of young females. Group O Rh positive RBC is our first choice to support patients with trauma who cannot wait for type specific or crossmatched blood. Those who do survive the emergency conditions can be reverted to blood of their own type without problem. Acceptance of Rh positive emergency transfusions by physicians giving emergency care can prevent unbalanced shortages in a regional blood supply system.
  10. We too have a DxH600 it took a while but we did validate the instrument for body fluids. The higher counts correlated better than the low counts. Is there someone you can get samples from close by? We basically manually count all clear samples as they do not correlate. Our linearity is for body fluids is 10-66,000 for WBC and 150-5M for RBCs so CSF really cannot be done on the instrument unless it is cloudy.
  11. Did you talk to your analyst or technical support because I was thinking that the software in the instrument now does that for you.
  12. We used to preform these but we now we get to send them out as part of a panel. We had a separate order so that when we did the differential we could count the bronchial epithelial cells with the WBCs. We did a 100 cell differential on a cytocentrifuged slide.
  13. Hello alialameen, Welcome to PathLabTalk. Please feel free to browse around and get to know the others. If you have any questions please don't hesitate to ask. alialameen joined on the 08/23/2019. View Member
  14. True Scott, but these people don't exclusively make anti-D; they could make virtually any specificity, even if D Negative blood had been given. For example, if they had made an anti-c, they would be in equally in the deep and nasty, if they have another emergent situation in the future, and are given rr units!
  15. On the other hand, if those 15% are in another emergent situation in the future... Scott
  16. We are currently on Client Server 5.67 PP 33.
  17. Roughly speaking, it is 15% hyper-responders, 70% normal responders and 15% non-responders (but those figures are rough). I tend to agree with your last sentence John. I was thinking more in terms of a single unit in an average sized adult.
  18. I'm sure Malcolm can give you the hard numbers and details but keep in mind that not every D- person responds the same when given D+ RBCs. Some will develop anti-D with as little as 100 microliters of cells or less while others will never develop anti-D no matter how many units of D+ RBCs they receive. Then everyone else is scattered around in between these 2 extremes. Then throw in the males and women who are beyond child bearing and it becomes even more complicated. I fall into the category believing that try to prevent the formation of anti-D after a transfusion event, especially one of multiple units is counter productive and an effort in futility.
  19. We used to get them from time to time. We just use a generic body fluid cell count and diff order. Scott
  20. You would want to check the Ortho Instructions For Use (all Ortho IFUs are online) for stuff like this. I believe the MTS diluent is listed as being usable until its label expiration date (opened or not). The notes about QC are there also. I am pretty sure our Ortho customer rep went over all this stuff with us when we switched from tube to gel years ago. Scott
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