Leaderboard

Yee ha! My thoughts of October were correct - and THAT doesn't often happen (I think of zebras instead of horses when I hear hooves!!!!!!!!!!!).

When we used gel and had a problem like that we repeated the screen with tube. If the tube screen was negative, that's what we reported, but noted the problem with the gel testing.

I have a paper mache Santa living with me that has celebrated almost 100 Christmases in 3 family households - I treasure him and the memories he brings with him. Merry Christmas to all! and a wonderful New Year!

Interesting case.

The patient is a DIIIc D variant. The variant gene controlling this expression of the antigen has D gene exons 1, 2, 4-10, but has exon 3 of the CE gene. So it's a hybrid of the D and CE genes.

Hello, I am currently working in a small hospital in North Carolina as the Blood Bank Lead. I have over 10 years of Lab experience, over 8 of those in Blood Banking. Most of my experience was gathered at the Naval Hospital in Portsmouth, VA. I am now in a leading position and it is exciting and stressful at times. Not having my technical supervisor at the palm of my hand is a big change, but I do like the challenge. This site has given me a lot of information when I hit a dead end. Thank you all for that!!! I'll be posting some questions shortly and hopefully join some discussions. Serafin

Welcome! I found the wealth of knowledge on here invaluable when I was in your position

I will start the ball rolling with how we handle some of the issues you have addressed: 1. Antibody is present, but not ID'ed yet, and crossmatch is compatible: We have a form that states that the antibody has not been identified, and although the crossmatch is compatible transfusing it does carry some increased risk because it has not been screened for the corresponding antigen. Ordering physician has to sign the form. (Pathologist is not usually notified.) 2. Patient has a history of a clinically significant antibody and the crossmatch is compatible: We have a form that states that, plus the comment that transfusing it does carry some increase risk because it has not been screened for the corresponding antigen. Ordering physician has to sign the form. (Pathologist is not usually notified.) 3. Antibody is present, but not ID'ed yet, and crossmatch is incompatible: We have a form that states that the antibody has not been identified and the crossmatch is incompatible and carries an significant risk of a possible hemolytic transfusion reaction. Ordering physician has to sign the form. Pathologist is notified that we are issuing incompatible blood. The above situations are spelled out in our policies/procedure manual. In any of the above situations, if the supervisor or assistant supervisor is present they are consulted and get involved in the situation (to make sure we are doing the best/safest thing for the patient.) If supervisor or assistant supervisor are not present, whether they are consulted/notified depends on the expertise/experience of the tech involved. All staff are certainly welcomed to call us at any time, but a few of our experienced techs are comfortable handling the situation. Donna

Thanks Malcom and Jayinsat. I had found the same statement in Daniels. Our reference lab eluted a very small quantity of anti-Di a from the post Tx red cells, so it does appear this was an immediate TR due to the anti-Di a possibly exacerbated by the hemolysis from the sickling. All other Di a pos cells had been removed from peripheral circulation within an hour. Interesting case. We will now AHG crossmatch her each time as we do not screen or type for low-incidence Ab/Ag either. thanks!

I'll run an LIS report and see what kind of antibodies we've eluted from samples with 'm+' DATs.

Personally, I think this inspector is completely over the top, and I agree with you that they are not designed to test the same type of antibodies. You could be really sarcastic, as would I, by telling him or her that you have correlated these techniques, by the fact that all of your patients had survived the transfusions following the use of the techniques!