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Just wanted to comment that starting 6/27/2016 I will become the interim Blood Bank Manager for the Cottage Hospital system in Santa Barbara, California. Looking forward to the challenges and opportunities this will bring my way.

Yes, it very much depends upon the sensitivity of the test being used, and on the catabolic rate of the breakdown of the immunoglobulins in the person to whom the anti-D was given. Remember that the figures given in, for example, Mollison, for the half-life of immunoglobulins is only an average, with the normal bell-shaped graph applying, and sometimes the "normal" for a particular individual will be well outside the two standard deviation mark.

we don't do any daily checks weekly - clean and check volume delivered quarterly - timer check semi annual RPM check annual - functional operation - check buttons, reactivity and confirm validity with check cells annual - change tubing and tube holder inserts Liz

The brighter colored unit may have been from a smoker so contained more carbon monoxide. I would prefer the darker one, I think. Blood bag plastic can also affect color somewhat. At least that is what I remember when my supplier changed blood bag vendors once.

we do like Liz but always wanted to change to what you are doing. There is a lot of literature out there that you could share with your pediatrician about recommended cord blood testing. Maybe you need to get your pathologist involved.

We do a cord eval work up (ABO/Rh and DAT) on infants born to Rh neg, group O mothers and mother's with clinically significant antibodies. We hold all cord for 14 days and determine ID my MR number if needed, which doesn't change. The DAT is only done within 24 or 48 hours.... I'm home and don't recall at the moment! Liz

Your new Pediatrician should treat on symptoms, rather than laboratory results, but order laboratory tests to prove the symptoms. It would be a lot cheaper, and would also show that the "Pediatrician" actually deserves the title.

I think the patient is going to be in trouble. At this point there is not much we could be doing differently . . . except maybe type the patient for k along with the initial K typing. Fortunately those k/Kpb neg pts should be few and far between.

According to the AABB Association Bulletin 16-02, if you detect an actual antibody and need to do an AHG crossmatch, you can treat the K-/antigen- donor RBCs with DTT before doing the crossmatch. If you have identified and honored all of the underlying allos, your AHG crossmatch would be compatible :-).