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thanks, Sheri!

Welcome tirdbirgler.

Hello tirdbirgler, 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. tirdbirgler joined on the 06/09/2023. View Member

I worked at a site that sent cards. Never did any good. For all the work there was no benefit. As for the chip...pass.

Jason Bourne all over again!!

We don't issue cards to patients with antibodies. I've discussed it with several of our medical directors, but none of them have been very enthused. They feel that most of the cards will be lost, forgotten about, or the info won't get passed on to us. Based on our past experience, I can't make a strong case. Our current medical director is a believer in Med Alert bracelets for the scary stuff. I've seen only a few cards, under the following scenarios: A few times: nurse is checking out blood and says 'Oh, the patient showed me this card about an antibody or something. Did you need to see it?' YES, before you transfuse! Twice: nurse has started transfusion and calls Blood Bank - 'Mr XYZ showed me a card about an antibody or something today (or yesterday). Do you need to see it?' YES, STOP THE TRANSFUSION! and once, once only - as the patient was being admitted on the floor, the nurse called and said the patient had a card about transfusions - 'Do you want me to fax you a copy?' YES! Gold star for you! Sometimes I wish we could put a chip in the scruff of everybody's neck that had all that info loaded on it - allergies, antibodies, med history - wouldn't that be handy.

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Agreed. I would however like to add the caveat that some physicians do not understand the risks associated with antibody history and uncrossmatched blood, so getting a pathologist involved to ensure the situation is truly life/death.

I would not use an enzyme treated screen as my only method for exactly that reason.

OMG!!!!!!!!!!!!

Had a lot of hospitals saying patient has a Vel when they should have said V

Believe me when I say that you are lucky!

I have never encountered a patient that says they have antibodies unless they have a card.

For an antibody screen “Neg” or “Negative” has been historically used. This may have been heavily influenced by DOS based computer systems that had very limited memory so “Neg” made sense. Reporting a SCREEN as negative seems logical to me, however a work-up requires more detail as Malcom’s described above.

We would write something very similar in such cases, but would always mention the specificity of the antibody that is no longer detectable, in an effort to avoid anamnestic responses.

I meant that they would NOT report it as "Negative", or "No Antibodies", but WOULD report occasionally as "All Clinically-significant Allo-antibodies have been Ruled Out using etc.", or words to that effect.

Stop blaming the Canadian Smoke. We in Canada, do result as No Antibodies detected. If the patient had an antibody in the past, that is maybe below detectable limits, but was previously identified, those are also in report as historical and as such the patient would have a full crossmatch in gel as well as phenotypically matched for previously discovered antibodies.

Thank you very much Malcolm - you're the best! If you would clarify in the second paragraph please - worth their salt "would" or "would not" report out... we're filled with Canadian smoke here and it may be causing me confusion

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Welcome Becky.

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In the UK, it is STANDARD practice in all laboratories that I know to use either the phrase "No Antibodies Detected", or, more frequently, "No Atypical Antibodies Detected", as the latter also includes such things as the iso-antibodies of the ABO and H Blood Group Systems. Indeed, some go further still and use "No Atypical Allo-antibodies Detected", as this covers such findings as an auto-anti-H, auto-anti-I and auto-HI, as well as the ABO and H iso-antibodies. These phrases do not mean that there are no atypical allo-antibodies detected. It would be an incredibly rare set of screening cells and antibody identification panel cells that would both express, for example, the HJK antigen, or any other genuine low prevalence antigen. In some cases, where an atypical allo-antibody IS detected, but it is known to be clinically-insignificant (such as anti-Kna), we may use the phrase "No Clinically-Significant Atypical Allo-antibodies were Detected" (or words to that effect). One thing is for certain, and that is that a UK Reference Laboratory (and most hospital laboratories) worth their salt would report out as "Negative", or "No Antibodies", although, even using the phrases I've quoted above, occasionally the phrase, "All Clinically-significant Allo-antibodies have been Ruled Out using etc.", or words to that effect. MIND YOU - you have to remember that I am RENOWNED for being a pedant - but I learned it from a few good sources; Peter Issitt, Carolyn Giles and Joyce Poole (to name but three).

Is anyone using the phrase "No antibodies detected" in resulting an antibody screen? I know "Negative" is commonly used but I remember using NAD someplace in the past - and seeing it through the years. Just thinking that it is clinically more truthful than a flat out NEG result. All detection methods have their caveats and can miss some patient antibodies - manufacturers have disclaimers in their IFUs. Maybe the patient's antibody is below detection with the method. Could also avoid finger pointing by the provider (or worse - a lawyer in a malpractice suit) if a patient DID have complications (or worse) and they were recently transfused. Some reference labs result as NEG for the serum studies but then it goes on with the Additional Comments - all clinically significant alloantibodies have been rules out using etc.

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