Transfusion Services

If the Kleihauer calculations are for seven (or more) 300 mcg vials of RhIG (assuming persistent fetal Hgb and weak D have been ruled out), are there precautions for giving that much? Is it effective? Is there a number of vials that is just too many? I have heard of concerns for hemolysis, which are sometimes mitigated by spreading out the IV doses and by giving steroids. I vaguely remember the idea that over a certain number of doses it may be hopeless. Is the approach different if due to transfusion rather than a FMH? Does anyone have any actual guidelines or evidence?

Is there any FDA/AABB guidelines for entering volume for apheresis red cells when received in the inventory? Any guidance is greatly appreciated, thanks.

ALLOHOPEfoundation.org I just learned of this organization so wanted to share their name.

Does anyone have any references for case reports or policies of giving ABO incompatible RBC units when a hospital runs out of O blood? We have always planned to never run out of group O RBC units but, the more limited availability of O RBCs, the current likelihood of mass casualty incidents, and the remoteness of some of our hospitals, we want to gather information to inform a policy on why we would or would not allow this in extreme emergencies. We want to discuss it now, not in the middle of a crisis. Even case reports on accidentally giving ABO incompatible blood could inform us. I can get the fatality data from the annual FDA report, but I have no data on cases tha…

We have an OB patient in to deliver who typed in gel anti-D as a solid 2+. Control is neg. We have typed her 3 times before in recent years using the same methods and she has always tested D negative. Most recent A Neg type was last November. Now with Albaclone anti-D, she is negative at IS and 37 but 1+ at AHG. Her prior baby was Rh neg so no attempted fetal screen test then. This baby is 1+ at IS with the Albaclone anti-D and 3+ at 37C and AHG. We don't usually run cord blood Rh types in gel. We will recommend the patient be sent for molecular testing. My question is what would make her D antigen strength change so much (or make Ortho's gel cards change their sen…

Has anyone used this book from AABB: ON-CALL MANUAL: A SYSTEMATIC APPROACH TO SOLVING COMMON ISSUES IN TRANSFUSION MEDICINE? Is it good for a new BB supervisor or generalist pathologist?

The small hospital I work per diem at recently switched all massive recipients to getting O positive. Even Rh men and women older than 50 whose Rh is unknown. I’m confused. Are we giving Anti D antibodies to 15% of our men now if doctors call a code massive ? I am retired with decades of experience and came back to work 2 days a week.

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.

Can anyone recommend a way to make up Elution Blinds aside from using previously analyzed specimens?

If you are doing CcEe antigen typing on the Vision, what are you using for QC? I had been using extra tube panel cells spun down for my controls, but it seems that the cell % has been reduced by the manufacturer to around half and I don't get enough cells after spin down. Cutting corners maybe?? I'm having to double the amount of tube reagent cells I need to spin down. I can alternatively use unit segs for R1R1 and R2R2, but with my inventory size I have trouble getting r"r and r'r. Ortho has only recommended that we use unit segments as they didn't have any other commercial QC to offer. Vision will only accept centrifuged blood as a control type for this, so no…

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.

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?

My hospital is developing/updating their response to a Mass Casualty. We are a 250-bed community hospital with limited blood product availability, a busy OR, ER and very busy L&D. What are some guidelines/suggestions from other Blood Banks with similar capacity? The project lead just wants a cooler of blood in the ED but I am uncomfortable with that...

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!

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

New Blood Bank Technical Lead. I have a lot of experience in gel but have recently started a new job in a facility that uses Solid Phase with the Echo Lumena. I recently reviewed our ABO policy and it states that any Rh negative result for a patient without history must be confirmed by tube before resulting. Is this a recommendation from Immucor? I can't find much about the limitations of the CMT plates. It would also be a huge help if anyone was able to point me in the direction of references for Solid Phase ABID troubleshooting? or is anyone willing to let me view ABID Echo Lumena troubleshooting job aids so I can get a feel for that before reviewing/editing …

Latest issue of AABB News mentions that both LVDS and PR platelets have seven-day shelf-lives but ours from ARC are still 5. Can someone explain how we can get 7-day PR platelets? Is this an ARC problem? We really don't want to start using Verax on LVDS platelets because we hope that more improvements are coming to platelet dating soon. Cold stored can be used only for bleeding patients so we couldn't always use them up, they must be on standing order only, and we are 4 hours' drive from our supplier for getting more RT plts.

How are you transfusing cryo to a neonate?. Issuing single cryo unit with filter? Pulling a syringe through a 150u filter starting with a 5 unit pool? Thanks for any information!

HAD A PATIENT THAT GAVE A 2+ REACTION IN ALL SCREEN CELLS AND WITH ALL UNITS CROSSMATCHED. DAT NEG, NO ALLOANTIBODIES. SENT TO ARC FOR WORKUP. PT ONLY REACTED LIKE THIS IN THE GEL SYSTEM. EVERY OTHER METHOD WAS NEGATIVE. IT WAS DETERMINED THAT THE PT WAS ACTUALLY REACTING TO SOMETHING IN THE GEL SYSTEM. IN FACT PATIENT WAS REACTING TO MTS DILUENT. HAS ANYONE ELSE EXPERIENCED THIS PROBLEM?

Has anyone successfully replaced the telescoping luggage handles on their MaxQ coolers, either with manufacturer provided replacements or "after-market" parts (Amazon?)? We have been using (and loving) our MaxQ coolers for about 4.5 years now. so much so that we've banged up the telescoping luggage handles pretty good. When querying the manufacturer about replacing the handles, they say "Nope! Gotta replace the whole box!"

Good afternoon, I am new to the group and this is my first post. Currently I am in California and my blood bank still does IS XM with gel xm when patient requires full AHG crossmatch. We use Ortho Vision. And we do electronic crossmatch on negative absc and no history of antibody. This was something new for me because when I worked in New Jersey, we did not perform IS XM along with gel xm since the LIS blood bank system can detect ABO incompatibility. I really want to discontinue performing IS XM on patient requiring gel crossmatch since our bb system can detect ABO incompatibility. However, I am new to California, I'm not sure CDPH requires to do IS XM …

Does anyone require patients to sign a consent prior to administration of RhIG?

Does anyone know of a program for training EMTs and Paramedics how to store and transport blood products as well as transfuse safely (which will probably be a rare task for any one individual)? And then how about a process to assess that they are remaining competent? I don't want to administer such a program as I already have a full-time job but would like to point them in the right direction or make clear what it would take to accomplish this. We might consider providing liquid plasma if they can check all of the required boxes. Our Air Ambulances already carry blood products, but they get a lot of opportunity to transfuse and are accustomed to following strict FAA r…

I see TJC standard QSA.05.06.01 now says: Each day the procedure is performed, and when a new lot of reagents is first used, the laboratory tests at least one vial from each lot number of antisera, reactive cells, and reagents for reactivity. The reactivity results are documented. Note: This testing includes positive and negative reactivity when recommended by the manufacturer. We have always thought that JC requires QC on all open vials even if they are the same lot number. Does anyone know when this changed? Or is there a different standard that contradicts it?

How does one develop Antibody ID samples for training purposes?