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Lol...I like the way you think, Malcom, but I don't have control over those decisions. Being a reference lab though, we push our efforts when testing referred samples. Micro reads are part of our routine if the patient has been transfused or pregnant within the last 3 months. Testing in PEG however is optional and PEG is notorious for revealing micro reactivity which often can not be identified. Having said that, I have on many occasions identified micro only, clinically significant antibodies in PEG. Would I recommend a hospital blood bank read micro? No, I wouldn't.

Thanks yan....the macro negative reaction in PEG at IAT was with the unadsorbed plasma and was tested with Immucor’s murine monoclonal Gamma Clone IgG. As Mabel pointed out, this reagent does not detect IgG4 and the anti-CD47 is....evidently.... an IgG4 antibody. In my hands, it was microscopic reactive so I believe in the future we will drop that read when faced with these patients.

This is not a popular concept but at some point we have to accept there are things we can not control. Once the blood leaves the blood bank we are at the mercy of other humans and as long as the human factor is involved there will be human error be it unintentional or intentional. Attempting to complicate a process will only provide inventive humans the opportunity of coming up with creative work arounds to circumvent your best of intentions. At some point you just have to step back, do your job and hope for the best. I had a corporate transfusion QA director who could not accept that human error could not be completely eliminated with out eliminating human involvement in the process. Her directives became horribly complex solutions with multiple, redundant checks and balances only resulting in increasing problems. Bottom line, pick your battles and fight those you have a reasonable chance of winning. Make suggestions, offer insight, provide training opportunities but at the end of the day realize that you have to accept some things are simply beyond your control and even your influence. On that happy note I'll step off my soap box and stop my philosophical ramblings.

Agree with TreeMoss. I would check your FDA paperwork and make sure it is correct. I took over a transfusion service and they had registered even though they did not need to register. I changed that right quick.