Leaderboard

missing serum reactivity, or apparent change in blood type following hematopoietic stem cell transplantation.Under those circumstances, your procedures should provide for compatibility testing using serologic crossmatch techniques." I haven't worked on the bench for a long time. Have I missed something? I fail to see how a serologic crossmatch technique will provide any meaningful information about compatibility if there is "missing serum reactivity".

Hmm, not sure. We have not been able to solve our "failure to issue in the computer" dilemma, but one thing we added was capturing all of the computer steps on a paper that is saved in the blood bank. We save a paper that has a sticker from the unit, we date / time stamp it and initial it. Our SOP says that the initials indicate that all of the safety / suitability checks have been done on the unit. We still investigate these events and try to resolve them, but those are not reported to the FDA. Nothing went wrong except for some record keeping.

I was wondering if Amy is a blood banker.

Definitely! I have gotten differing answers on previous questions depending who was on the other end of the phone at CAP.

I do so agree with you mollyredone. Sadly, in the UK, it is usual to have to perform a serological cross-match, using group O red cells if there is any hint of a mixed-field (even if the patient has, for example, been typed as group A for a decade, and a unit of group O blood was transfused the previous day). This pathetic attitude to the professional ethos of the laboratory personnel is insulting in the extreme, and, because the "mixed-field reactions" will be "reinforced" with each transfusion of group O red cells, if the patient requires frequent transfusions, the "discrepancy" will never be resolved, and precious group O units (in particular, group O, D Negative units) will be wasted unnecessarily. Worse still is when the patient has an alloantibody, such as an anti-Fya, when group O, Fy(a-) blood has to be selected for the group A patient (in my example), when group A, Fy(a-) blood may be readily available, leaving fewer group O, Fy(a-) units readily available for a genuine group O patient, with anti-Fya, who may require it in an emergency. Worse of all is when the patient has a complex mixture of common antibodies, or an antibody directed against a high=prevalence antigen, when there are only a certain number of group O units available in the country (and less donors, as numerous cryopreserved units may come from the same donor) and these units are wasted on patients who are patently not group O. RANT OVER - FOR NOW!!!!!!!

The way I read this, is "if discrepancies exist". Not if discrepancies existed (in the past). So if you have a discrepancy and resolve it, it does not exist anymore. So if you can't resolve the discrepancy currently with other techniques, a serologic crossmatch would be required, but if you followed through with your procedure to resolve the discrepancy, it is no longer a discrepancy.