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Yes, that is valuable for the treatment advice. For the transfusion decisions, my plan is to say, "don't unless necessary", then, if there are enough compatible units and Ab titer is very high, start with a couple of compatible units. Once antibody has been bled out, then use random units and, if you can guess when the last few units will be given, make them the more compatible ones to reduce the RBC destruction in the coming days. If titer is lower or there are few to no compatible units, start with random units and try to fill the patient up with the (more?) compatible units at the end. Maybe with sufficient immune suppression as your article suggests, we wouldn't have to try to guess when the last few units will be transfused. We could keep the compatible ones for single unit transfusions over the ensuing days.

We would indeed!!!!!!!!!!!!!!!!!!!!!!!!!!

This is almost certainly NOT the paper that you wanted referenced, but it may help in an emergency. Win N, Needs M, Thornton N, Webster R, Cheng C. Transfusion of least-incompatible blood with intravenous immunoglobulin plus steroids cover in two patients with rare antibody. Transfusion 2018; 58: 1626-1630. (DOI: 10.111/trf.4648).

Years ago, I had a short blurb (maybe from Lab Medicine?) on how to transfuse patients with incompatible blood as safely as possible. It included the example of liver transplants and talked of "saving the best wine for last". Does anyone have a reference that covers how to transfuse (of course avoiding it unless life-saving) in the presence of multiple antibodies or antibodies to high frequency antigens? We have a patient with anti-S and anti-Dib. I have some plans for if a life-threatening emergency arose but would like to have a reference.

Did you know that in the UK they would be appalled that we might give K+ blood to a female with childbearing potential in the US because we don't routinely K type either the units or the patient? D isn't the only immunogen out there (although it is certainly very immunogenic, and the number of positive donors outnumber the number of K pos donors). Still, there are other risks than making anti-D that some are equally concerned about.

Does anyone have EMR ID's for the new cold stored platelets to build the product in Meditech? I have sent a task to Meditech and am getting ghosted when asking for an update on this. Surely we are not the first to build this product in BBK?

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Hello Marcus Mota, 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. Marcus Mota joined on the 05/21/2024. View Member

Hello STADNIUK, 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. STADNIUK joined on the 05/20/2024. View Member

Intrinsic factor Intrinsic factor Submitter Cliff Category HemeLabTalk Submitted 05/22/2024  

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