Transfusion Services

CAP standard TRM.40130 is a new standard that deals with alternative control procedures. It states "If the laboratory performs test procedures for which control materials are not commercially available, there are written procedures for an alternative mechanism to detect immediate errors and monitor test system performance over time. The performance of alternative control procedures must be recorded." We use the Ortho Confidence system for gel. We also use AB Plasma (we aliquot one unit of expired FFP and use it until gone) for our reverse type in confidence cell 1, to test the buffer part of the card and also to test our screening cells in the IGG card to make sure t…

Anyone else using Vitalant? We do partially. Wanted to know if you've gotten any information on how frequent this low-yield supply will be? I get why they're supplementing inventory with these, but I'm having trouble getting information from my account rep. This involves a lot more than just turning on product codes for us, so putting out feelers. We're so remote I don't have a good network of other users.

Good morning. Anyone who uses this BB computer software would be willing to share their current SOP if your facility uses this feature. Currently it's only being used by Supervisory staff if the patient expires and we never receive a T&S sample. I'm looking to train my entire BB staff to use it for Emergency Issue and MTP. Thanks in advance.

Why are haemolytic reactions excluded from definition of ATR? SHOT in UK only defines Febrile, Allergic and Hypotensive Cheers

Can anyone cite any regulations that stipulate what must be documented in an electronic transfusion record? I am looking at times when the usual electronic documentation wasn't used, and they manually document in a note or on a form that gets uploaded. I can't see any Joint Commission standards that state that they must document the DIN, product code, who transfused it and when. I see medication regulations for the time and "dose" which may apply because the FDA considers blood a drug, but nothing says specifically that they need to include the product code or even the DIN. This isn't the old days when paper transfusion records were returned to Blood Bank for record k…

We use the gel system for most all of our testing. Occassionally we have problem false positives that occur with the gel. When sending out "positive" antibody screens for identification the reference lab blood bank will recommend we re-screen the patient using tubes since they got negative reactions using tubes. Our problem is that we only have the 0.8% cells. We don't do a high volume of blood banking at our hospital and it would not be economical to keep the 3% cells on hand. Does anyone convert their 0.8% cells to 3%? If so, how? and is this acceptable?

Case for discussion: I received a sample for 35 years old female patient Multiple delivery all by caesarean section Results: BG: A negative Du : Negative AC: Negative DAT: Negative IAT: positive (3+) all 3 cells Ab ID: 11 cells All positive (3+) Then repeat IAT & Ab ID Incubation at room temperature All positive (3+) (Gel technique) (Orthovision)

Hi all, perhaps this is a silly question. We are a growing blood bank that works primarily in gel. We only ever have 2 available panels to use at a time, Ortho Panel A and Panel B. We are bringing in a tube panel to use as an additional resource (Immucor/Werfen Panocell). My question is, if we are working up an antibody ID in gel and need additional rule-outs, can we use selected cells from the tube panel (using tube testing method) to complete our workup? Can you piece together gel and tube to support one antibody ID? I cannot find any guidance on this in the technical manual, any insight is appreciated. Thanks in advance!

Hello everyone, I am so glad I found the group for all the blood bank information. Now, I have FDA registration question. My sister hospital provides blood products to the infusion center (xm RBCs and platelets) that is at least 10 miles away (infusion center is part of the hospital system, same name). We reached out to FDA CBER for information, but no response. All the transfusion services at the hospital have CA biologics license. If our sister hospital provides blood products to the infusion center outside of the facility, do we need to apply for FDA registration? So far this is what i found on the website. However, the legal terms are so confusing. Can anyone …

How are you all interpreting the FDA's guidance to use CSP "where room temperature platelets are not available or their use is not practical"? What is "not practical" for your site? If using the RT platelets means that the OP transfusion patient has to wait until more arrive from our supplier 4 hours away, that seems impractical to me. Is it "impractical" that we will have no platelets in stock that we can give the septic oncology patient (non-bleeding) because we gave them all to the MTP patient rather than giving the MTP our CSP and holding onto a RT plt for other critical, but non-bleeding needs? Should we give the CSP to the trauma and hold the RT plts only if we k…

Does anyone have a lead where I can find the gel crossmatch rack? Marketlab has none. I tried Fisher Scientific.. nothing. I am looking for this type of crossmatch rack where I can do tube and gel on the side... Orto doesn't have one either.. Help. Thank you!

Hi all, We have a 28/40 pregnant patient, group O neg with an antibody that fits exactly with anti-D on our IAT panel but is negative in enzyme. Previous sample reported by our reference lab as having non-specified antibody. Anti-D (and anti-E) could not be fully excluded. No record of prophylaxis. Any ideas? Cheers, Rich

Can someone help with managing a build for reconstituted RBC blood product for a neonate exchange transfusion in Soft bank and Epic system. What billing codes are associated with this product? Thanks, Eva

Does anyone use the Optix Gel card reader with their Ortho Workstation? If so, what are the pros and cons?

Recently, I had a situation that bothered me and I wanted to reach out to this knowledgeable group for opinions. A patient was going into the organ donor process. They wanted 4 or 5 units of blood. Unfortunately, the patient was O Negative and I could only offer them 2 units. So, the group handling it contacted a blood supplier and got three additional units and brought them into my hospital. Then proceeded to use them during the course of the process. My first question, should these units come through my blood bank? How can they not have these units tested at all? No ABO recheck, no crossmatch, nothing. Now according to them as the patient has passed, they can do that. …

Some of our OB doctors are very confused about antigens vs antibodies and all of our case-sensitive allele terminology. They sometimes order antibody screens on fathers of babies carried by patients with antibodies capable of causing HDFN. Or recently, a screen got ordered in error in addition to the antigen typing and the doctor was very confused why the father was positive for c & C but had a negative antibody screen. Before I try to write up something succinct for them (and their MAs and midwives), does anyone know of any materials like this already in existence? It probably needs to have images. It can't get down in the weeds with us blood bankers. It needs to e…

Does anyone have any information on performing antibody titers using manual gel on the Ortho Workstation? Would you be willing to share your procedure?

I work at a trauma center that uses Low Titer Group O Whole Blood. This year we have basically been forced to copy another facility's protocol where they transfuse up to 10 units of whole blood during MTP. From a logistics perspective, it's great for the blood bank and the trauma team since there are fewer bags to manage. However, is there any guidance about how/when you can safely switch back to type specific products for non Group O patients? It's "low titer" but it's not zero. If a patient gets more than 4 LTOWBs we add a Use Group O RBC's instruction. We do this because the only articles that I can find about evaluating LTOWB show that it's pr…

Are there any guidelines available for having to require a QC performed when converting 3% RBC suspension to 0.8%? Even when the panels are in-date? If you are doing this at your facility, can you share your approach?

I feel like I saw that AABB added a standard that requires us to do correlation testing twice per year between antibody screening methods. Can anyone tell me which standard it is? I would also love to hear what you do for this standard when we expect Saline, Gel, PEG etc. to react differently and use those differences to avoid weak warm autos etc.

Can someone please cite a regulatory requirement that our workers need to document that they have read revised procedures? I consider this training if they can learn what they need from reading the new SOP (without more formal training), but I don't know if documentation of it is required or just tradition.

Now that we know that activated platelets are good for plugging holes in bleeding patients, if we get a platelet unit back out of temp because someone stuck in the cooler on the ice with the RBC units, would it be safe to use in an emergency in a bleeding patient? I'm sure we would need to get pathologist approval to use it outside of regulations. We are ~4 hours from our supplier and stock 3-6 platelet units. All input appreciated.

Hello everyone.................. I hate anti-a1 to be honest with you... I never liked it.. Patient's history blood type: A pos. no discrepancy noted on the other hospital.. One hospital reported inconclusive antibody result. Received 2 prbc within 30 days. Patient is at my facility. Now has back type discrepancy. ABID- Anti-M and inconclusive. Before getting the absc result.. my tech decided to work on the extra reaction backtype discrepancy thinking that it's a subgroup.. anti-A1 lectin was negative and RT tube screen was positive at IS. A2 cell was negative at IS, but when I let it sit for 15 min.. it was 1+w positive. So…

Hello everyone, We will be moving to a new manufacturer for daily QC to be run on the blood bank gel analyzer. I need help on what the validation plan should include in order to establish the new QC works as expected. Any advice, details or examples would be very helpful. Thank you.

Patient is identified as having “warmautoantibodies” in our lab with transfusion instruction to give C, E, K neg units. Patient was phentotyped for RH and Kell on the first work-up. When patient came back for a type and screen, 2 cell screen were 2+, ABID were all 1+ except for one cell being 3+. DAT was negative and when I performed tube screen and autocontrol, they’re both negative. When I looked at the previous work-up, no transfusion has been done since 2018, screen and ABID also have panagglutination reactions. DAT and Tube screen were also negative. My supervisor asked me to do an elution and it came out with panagglutination reaction (3+ and 4+)…