UK Guidelines

New MHRA document attached detailing requirements for labs performing electronic Issue. Some very good points in this and definitely a bit of work involved. It seems implementation PLANS are required by 31st July 2010 with risk assessments on current processes used. Nice to see there "should be evidence of senior management support (at Trust/ Board level) for any resource requirements to implement the plan". Would be good to discuss. thanks MHRA Guidance on Electronic Issue.pdf

I wanted to get some other opinions on this subject - Guidelines say that a diluent control should be used if the antisera used in the grouping contain potentiators, if a cold auto-antibody is present or where it is recommended by the manufacturer of the reagent. Please correct me if I am wrong here. Most (if not all technologies) incorporate a negative control directly as part of the test. So, assuming the test is automated, without the option to add a control to each test, how would people feel about the removal of this control? Thanks

Hi All If patient has 2 known historical blood group, do we still need valid group and save at time of platelet transfusion? I am trying to find out in guidelines but unable to find. If patient is on regular platelet transfusion how often should we repeat group and save and why?

While this seems a fairly obvious answer, we’ve had issues lately. Two weeks ago, we had a cord sample give a ‘?’Reaction in Rh D in the newborn card. As per our sop, this was rerun and came up negative and to be sure, the bms washed the cells and checked the group in test tubes. It was weakly positive in one clone of Rh D, only detectable under the microscope. This was later confirmed as weak D by the reference lab and the mother was dosed appropriately with Anti-D. Historically, we’ve always checked negative test tube Rh D under the microscope and this rarely caused problems. Since this incident though, we’ve had problems with weak (+/-) reactions which are conf…

Is this a requirement for heterozgous HbSC?

I was reading the BSH Guidelines for the Estimation of Fetomaternal Haemorrhage, and I had a few questions: 7.2 Slide Preparation In my current workplace, we do not dilute the sample, and my previous workplace did. I could not see a significant difference on the slide that was made and found them both equally adequate, but I was wondering if other have any input on them 7.3 Controls We currently prepare the control slide a week in advance and not fix or stain them, until required for batch testing. I have checked all the slides after it had undergone AE test, and all of them had been adequa…

Having read the BSH guidelines 4.7 about grouping anomalies “ reagents may cause IgG antibodies such as anti-c to be detected” Has anyone seen this or any other antibodies anti-e and what reagents did you use (A1, B cells typed as cde) ? Thanks Guidelines-for-pre-transfusion-compatibility-proceduresin-blood-transfusion-laboratories.pdf

We are starting to prepare for iso in our bb, regarding traceability of reagents, I do not think this applicable in blood bank, is it? Any one has the experience with this?

HI all, SHOT has gathered data and recommended minimum standards for hospital blood transfusion for staff qualifications. Is it just recommendations or we have to strictly follow the criteria because UKAS has accepted this criteria.

Hi all, I'm trying to find out the similarities and differences around the world (but particularly in Europe) for guidelines related to measuring fetomaternal haemorrhages and issue of anti-D. I'm particularly interested in which countries issue anti-D and don't estimate the FMH, what formulas countries use for calculating doses, what tests different countries use, whether the FMH is measured in whole blood or packed cells, whether different countries use the 1.22 muiltiplier to account for the different sizes of red cells... Not a small list I know. I've found a few international guidelines already so here are some useful links UK guidelines for all T…

How do people report patients with prophylactic anti-D? We report them as antibody screen negative but a comment stating the remains of prophylaxis detected. I'm not convinced we should be saying it's neg if Anti-D ig is present. I'd be interested to see what others do and if I'm getting my knickers in a twist over nothing!

Hi, everyone Are there any guidelines that we are following about providing HEV neg blood ?

Hi All Just a few questions on ruling out. Section 6.2.4 describes at least two examples expressing the antigen I am assuming this applies to IAT and Enzyme testing reactions separately (assuming antibody reacts by enzyme) and also that this can be homozygous or heterozygous expression of the antigen ? It does state in 6.2.6 that a single example can be excluded if homozygous for anti Jka/Jkb, S/s and Fya/Fyb. Thanks

Hi all, I have been reading over these new guidelines and am interested in people's thoughts on the following paragraph There have been several cases in the UK where immune anti-D has been mistakenly assumed to be prophylactic without a validated method of measuring the strength of serological reaction or taking into account an accurate history (2010 SHOT Annual Report). It is important therefore that regardless of any prior administration of anti-D Ig, any anti-D detected at 28 weeks should be quantified and the results made available in the woman’s hand-held and hospital records. At present we do not send patients sample away for quantitation if they have been recently…

US accrediting agencies require that transfusion services perform serological testing on a donor tubing segment from Red Blood Cells to confirm ABO/RH. Is this also a requirement in the UK?

Can anyone tell me if we have a universal way in identifying an antibody using panels? Are there any textbooks available for students that cover these steps?

Dear All Can I pick your brain about something. Under the UK Guidelines, there is no requirement to perform a post-partum antibody screen on the mother, and no requirement to perform a DAT on the baby if the mother had no antibodies during her pregnancy (or in the past), and the mother was given routine anti-D immunoglobulin prophylaxis during her pregnancy. We are introducing RAADP in The National Maternity Hospital this year and we are wondering how did labs in the UK approach dropping the DAT on the cord. We use BioRAD 6 well ID-Cards (DiaClon ABO/D + DAT): A, B, DVI-, DVI-, ctl, DAT As we sometimes (not often) see one D well negative and the other D well pos…

Hi All Under the BCSH Guidelines there is no requirement to run a DAT on the baby if the mother had no antibodies during her pregnancy, and the mother received RAADP. I am wondering for those of you who use DiaMed ID-cards for newborn grouping, what card do you use to group the baby?

Hi there I am interested in hearing people's opinions on which antibodies required to be titred during pregnancy, and Also any other info which is considered to be important in the antibody titre process, ie running against a standard or previous sample , and also any important points which should be considered in the reporting of titres. Many thanks Tricia

If we are to transfuse MB treated products for anyone born after 1996, why doesn't my local blood service supply MB treated cryoprecipitate?

New BCSH guidelines just out yesterday:- http://www.bcshguidelines.com/4_HAEMATOLOGY_GUIDELINES.html (scroll down on link to see guidelines list) Includes changes in time limits for use of stored blood depending on pregnancy or last transfusion

Hi I’m from the UK and I was hoping that some members of this board are familiar with the IBMS portfolio for haematology and hospital transfusion. My training officer doesn’t know much about this and other members of staff are reluctant to help me. Can anyone please given some advice?

Hi everyone I would like to ask a question related to the 'Guidelines for compatibility procedures in blood transfusion laboratories' prepared by the BCSH. In section 8.6, The immediate Spin XM, there is written that this technique cannot be used in patients where ABO grouping reveals very weak anti-A or anti-B (except in group AB patients). I would like to know if this weak reaction can be quantified; for example: you cannot use the IS if you obtain a 2+ reaction or lower using CAT. I think that a laboratory should have a standard cut-off reaction to determine which patients can have units allocated by the IS. I would like to know your opinions on this matter. Best rega…

Another useful forum to begin discussions on the various UK Guidelines we have for Blood bank practices. This would be a very good area for more junior staff in our depts to begin to familiarise themselves with these documents. Each time I go back to have another look at various BCSH guidelines etc, I am amazed at how much information these contain . I am very grateful to the folk who have spent many hours researching and writing these docs, and consider these the key to helping us standardise and improve our practices.