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We do the same. In the past I tried to doctor samples for ABIDs, and they were either non-reactive or 4+ at immediate spin.

Yes, when there isn't a true massive, it is more likely the patient may make an antibody. That said, we have the same procedure here as you Kym: we give O pos to males and women over childbearing age for ANY emergent release red cells. If they only get 1 or 2 units, then so be it. This is part of the battle of using inventory appropriately and calling a code/massive appropriately....and never the twain shall meet.....

Technically, any sample you don't know the answer to is "blind" to you, so any regular patient with no history can be used for a blind blood type for example. Yes, for DAT and FMH it's harder, but we typically use the CAP samples as Bet'naSBB said, rather than try to make up samples that are not quite right.

It varies from no reaction to lethal hemolysis. Anti-D is not entirely predictable in causing severe hemolysis. But mostly bad stuff happens :). This is true to some extent for anti-A and anti-B, although these are more dangerous as they fix complement in vivo better than anti-D in general. Joe Bove (my original mentor) reported a case of a patient receiving multiple units that were ABO major incompatible with no reaction. Not typical, but illustrative of the variability.

Even without a transfusion reaction, the haptoglobin drops with transfusion of red cells. Lots of non-viable cells and free hemoglobin in many red cell transfusions. If you cannot see red urine, red plasma and a drop in hematocrit/failure to rise, it's not a hemolytic reaction. Haptoglobin plays almost no role in assessing hemolytic transfusion reactions, and, as mentioned, unless you measure it on the pre-transfusion sample as well, tells you almost nothing. LDH pre and post would be more useful in most cases. Don't bother with haptoglobin in most cases.

We use our CAP samples AFTER the results have been submitted and results have been received from CAP. We just finished assigning a BUNCH of "Internal Assessments" and "Method Comparisons" using our first batch of CAPs that we'd already received our results for. All these count as "blinds" for the staff. Instead of making 1 tech do the whole survey, we give each assignee one sample to do and then compare their results with those expected by CAP. works great! For FMH, we get two CAP "TMCAF" surveys per year. 1/2 the staff does the first and the other 1/2 the second so everyone gets a blind for FMH.

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Anemias and Myeloid Malignancies Anemias and Myeloid Malignancies Submitter Cliff Category HemeLabTalk Submitted 05/15/2024  

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PathLabTalk would like to wish all members celebrating their birthday today a happy birthday. ceciliafong (52)mozkowiz (46)rperguson (64)juneadt56 (68)Karnina (46)lateonenite (50)cook58 (66)Val2407 --

Where I work, it's up to the pathologist to request haptoglobin test on the transfusion reaction case.

How is everyone navigating creating Blinds Samples for competency? I have found that doctoring a sample with a positive control makes the results too strong/predictable (ex. FMH, DAT, etc.). Any help is appreciated.

I remember the great George Garratty telling me once that measuring haptoglobins AFTER blood has been given is an absolute waste of time, money and reagents, UNLESS the pre-transfusion haptoglobin levels have been measured. I believed him!!!!!!!!!!!!!!!!!!!!

Does anyone include haptoglobin tests in their transfusion reaction workup (probably just the extended workup when hemolytic reaction is expected)?

Yes this is my issue. Most of our “codes” are truly the old 2 unit unxm. Ie: they are NOT bleeding out. Get 2 units of o Pos bleeders. also many of these people are repeat offenders. Ie. Here for more fights or racing car crashes. Young guys. Not all not most. But many. And 80% of our codes called. Give ONLY 2 units of PC. What kind of transfusion reaction does a person get if they receive 2 units opos blood when they have Anti D ? Is it no big deal? What are symptoms? How bad a reaction is it?

Good morning everyone, We are in process of upgrading our Wellsky to the new version. My question is..... how do you attribute Psoralen Treated platelet in Wellsky? Our current Wellsky version can't connect that the psoralen treated is equivalent to CMV= and Irr product. So before I came to this hospital, the previous leadership decided to automatically attribute psoralen treated platelet as cmv= and IRR.... which kind of untrue.. cause it's equivalent.... Does anyone have Wellsky and have solution how to implement this change in the Wellsky? Thank you!

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We give Rh pos WB to any patient over 50kg that they call MTP on and keep it as the primary resource in our adult ED refrigerator. That being said, I have attached two articles concerning this very subject should you like to read about some studies done. Anti-D in Trauma Patients.pdf Rh negative risk with Rh pos RBC.pdf