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I would advise A+, BUT, I am not a doctor.

Enzyme-treated cells can be very useful in the hands of expert serologists who know the pros and cons of their use. Routine use by front-line techs is probably ill-advised. In this case, some level of feasibility testing might be useful before switching to an enzyme-treated panel, but I would hesitate to call it "validation". Each facility should determine if such a panel is useful to them, or if it would cause more problems that it would solve. As I mentioned in earlier in this thread - I believe these are FDA-license reagents and they do not require validation.

My personal opinion - no validation required. You are switching from one FDA-licensed product to an equivalent. Unless you plan to use it in a fashion contrary to the manufacturer's instructions it's a business decision rather than one of quality or performance. If you have an internal policy that directs you to "validate" in these situations, you should change that policy. Anything that an end user does to "validate" a commercial, FDA-licensed red cell panel is dwarfed by the process involved to get these products to the market. Perhaps more important is that the replacement product suit your facility's specific needs. The typical antigenic make-up of the panel you select should reflect your particular testing requirements. For example....if you have lots of patients with anti- D, a panel with lots of D+ cells my not be very useful.

We had graduated to doing ABO/Rh and DAT only on babies born to Rh neg moms. Then...........a new Family Medicine doc came to town and became the head of the OB committee and now we are doing ABO/Rh and DAT on babies born to all O moms as well. The new pediatrician head of the pediatric committee is perfectly OK with testing only the babies born to Rh neg moms - all our newborns are scanned for evidence of elevated bili before discharge, so a high bili is not going to be missed. We are hoping he can eventually win the day and we can go back to testing only the Rh neg babes. One category that we don't automatically get cord bloods on is the moms with clinically significant alloantibodies. I would like to see that change. If a pediatrician doesn't order a DAT on those babies, I find a hemo sample and run one - if it's positive, I would take that info to the medical director for followup with the attending.

We only routinely get cords on Rh negative moms & moms w/ a clinically significant antibodies. Occasionally a physician will request one on an O mom who has had a previously affected infant, but it’s not very common. If a baby didn’t have a cord performed, and there are concerns of jaundice later, we have a separate test order for the ABO/Rh/DAT drawn via venipuncture or heel stick.

It would be interesting to hear exactly why the new paediatrician wants to go back to this testing regime, considering that it has been known for decades that the DAT in a case of ABO HDN can be negative for a couple of days from birth, and only then become positive. May I respectfully suggest that this new paediatrician relies on his or her ability to look at the baby's symptoms, rather than his or her ability to read laboratory results. This way, more babies may survive.