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Certainly in the case of an anti-Vel, it can be vital to use serum, rather than plasma, as it can frequently only be detected by using an AHG that detects complement. I DO SO AGREE WITH YOUR FINAL SENTENCE.

I was taught, many, many moons ago, that prewarming should only be applied when the identity/specificity of the antibody is known/understood, i.e., you know what you're trying to avoid. Cold autos are probably the most commonly seen, but "nuisance" cold-reactive antibodies like anti-M, anti-P1, anti-Lea/Leb can also pop up and potentially be avoided using a prewarm version of an assay. These specificities are usually IgM class, are amenable to prewarming, and are generally considered clinically insignificant. Prewarming to "get around them" is often a good option. However, a cautionary note: There are cold-reactive antibodies that can present in a similar fashion that are clinically important - anti-Vel , anti-PP1Pk, for example. It can be dangerous to use prewarming to avoid these sometimes potent and potentially life-threatening alloantibodies. Prewarming may be a very useful tool, but as is true for very specialized tools, it should only be used and applied by trained and experienced operators who understand its strengths and weaknesses.

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we can only use it with tests that require the addition of anti-IgG - such as an antibody screen or full XM. we are not allowed to use it for IS testing such as reverse testing or ISXM. so - in my mind, I'd say it could be used when a patient has a cold-auto ab and you want to see if there are any underlying clin.sig ab's after the addition of anti-IgG if our reverse and/or ISXM are positive due to the presence of cold auto - we have to cold adsorb and retest with absorbed plasma.

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Oxygen transport Oxygen transport Submitter Cliff Category HemeLabTalk Submitted 05/03/2024  

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Under what conditions do Blood Bankers use a prewarm technique to exclude cold reacting antibodies?? I am looking to restrict the use of this technique to only when indicated but am having trouble coming up with an inclusive list of indications. Any input would be appreciated.

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Iron Iron Submitter Cliff Category HemeLabTalk Submitted 05/02/2024