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Well Muhammad, my immediate question is, does it matter whether the antibody is IgG or IgM, but the reaction is most certainly due to incomplete adsorption? That having been said, you could treat the plasma with 0.01 M dithiothreitol (DTT), which would disrupt the di-sulphide bonds that hold an IgM molecule together, via the J-chain, which will prevent the molecule forming agglutinates with the red cells, but it really doesn't matter whether the antibody is IgG or IgM (or, indeed, a mixture of the two), if the reaction is by enzyme-only. Indeed, within NHSBT, we do not bother to test adsorbed plasma with enzyme-treated red cells after adsorption.

Thank you so much. I am a Biomedical Scientist in the UK, and I am very interested in transfusion science and I am currently studying towards a specialist portfolio in Transfusion science. I have come to this forum with an empty 'bowl of knowledge', which I hope you will help me fill. Thank you again

I think that this has a lot to do with intent. If the intent is to hold the blood until it can be transfused, then it is storage. If the intent is to move the product from one place to another, then it is transport.

I agree with Malcolm - the IgG/IgM nature of the antibody is not relevant, and I would avoid tests with enzyme-treated cells in patients with confirmed WAIHA, especially after adsorption procedures. I know that some workers also avoid PEG when testing adsorbed serum in these cases, opting instead for LISS or even saline antiglobulin tests on the adsorbed serum.

Thank you, Malcolm.

Wow! Malcolm. Congratulations! You have indeed deserved it! From the little I have 'researched' about you. You are an inspiration, but can I achieve what you have? Hmn, maybe in 2 lifetimes. Congratulations once more.

Hello Muhammad Awwal, Welcome to PathLabTalk. Please feel free to browse around and get to know the others. If you have any questions please don't hesitate to ask. Muhammad Awwal joined on the 08/16/2018. View Member

Welcome

In answer to your last sentence Teristella - GOOD LORD YES! Turning to your first sentence, the problem with performing an extended cross-match is that, if, for example, the patient has either sprouted a weak anti-Fya, or worse, has made an anti-Fya in the past (unrecognised), but has not been re-stimulated for a long time. Either the units could both be Fy(a+b+), or one could be Fy(a+b+) and the other Fy(a-b+), and the cross-match may not detect it. This is because the red cells in the antibody identification panel are in a preservative that maximises the expression of the red cell antigens, but NOT the oxygen carrying capacity of the red cells, whereas the red cells in the units are in a preservative that maximises the oxygen carrying capacity of the red cells, but does not maximise the antigen expression of the red cells (and the Duffy antigens are known for deteriorating upon storage (as are the Knops antigens, but they don't matter). So, by cross-matching without performing a panel, you may be missing an anti-Fya, and if the screening cell that is Fy(a+b-) may have come from an individual who has the FYA/FY genotype, if these red cells have come from a donor of the Black ethnicities, but the human immune system is MUCH more sensitive than our tests, so you have a DHTR on your hands. This, however, is purely a personal point-of-view.

DTT SOP.pdf This procedure is based on the HemoBioscience SOP and the AABB SOP. Works for us. Prior threads on this topic have indicated that the DTT treated cells will not last long, so we do this only at need.

I got this message from a member, and they gave their permission to share. -------------------------------------------------------------------------------------------------------- Dear Cliff, First of all sorry that I haven't react in any way your welcome message, but 4 years ago when I joined the Hungarian Blood Bank and a bit later the Blood Bank Talk community (beeing a logistic expert) I was sure I would never be able to contribute your conversations. You know I had a foggiest idea what blood banking ment at all, and to tell you the truth even now I only guess what the majority of the topics are about. Anyway I thought reading the threads was an excellent chance to practice my English. So I became your diligent reader. Slowly I got acquainted with Malcolm, Deny Morlino, David Saikin, Auntie-D, Mable Adams, and the others and enjoyed so much their communication except for those horrible abbreviations... I must say I am really envy of your profession and the helpfulness and devotion what is so tipical of every single one of you. The event that is accountable for my turning to you is that soon I am leaving the Hungarian BB and continue my career in a business that has nothing to do with blood. I looked for the suitable point on the home-page to unsubscribe the e-mail list, but I failed. As fare as I noticed you are a sort of a system administrator here, so I hope you can solve my problem. I wish all the best to your blood bank community and farewell, Eva Jaszay Budapest PS: If you think so, share my letter with the others, and please forgive me my grammatic mistakes. -------------------------------------------------------------------------------------------------------- Eva, Thank you very much for your kind words, and this is an international forum, don't worry about your grammar enhancements. Cliff

As we wander along in our day to day duties attempting to solve problems and answer questions it is easy to forget the effect our comments may have on others. Thank-you Cliff for posting this letter. As you said this is a true international community where we manage to avoid politics and other hot topics allowing us to focus on our true passions for blood banking.