Leaderboard

1) The original antibody ID matched an anti-D, as did the eluate. 2) Just one source for anti-D testing. Its a poly-monoclonal blend. and... We are pretty sure the gentleman has NOT had any Rh immune globulin. Genomic testing is, indeed in process, as we have sent the specimen to our reference lab. The forward reaction with anti-D was a strong and clear 4+. A partial or weak D is unlikely. The rest is being processed at our reference lab this week. I will post results here... Scott

I just answered this question. My Score PASS

I just answered this question. My Score PASS

I just answered this question. My Score PASS

Hello, Scott, I have a few questions about this case. 1) What is the eluate result that "matched the original antibody ID"? Is it panagglutination or anti-D in eluate? 2) How many sources of anti-D did you use to type your patient? We use up to 3 or 4 sources in this lab if we have such problem in this lab. Here are the things that I usually do to figure out if anti-D is that of auto- or allo- .. 1) exclude the possibility of RhoGm or IVIG adminstration 2) Perform D typing on the patient's red cells using different sources of anti-D. (we usually have 4 or 5 sources). If D reactivity is found variable positive and negative reactions with different clones, perform genomic testing to exclude partial/variant D antigen. 3) If the patient is elderly male and recently transfused with D+ blood (or if you see mixed field in the D typing), perform cell separation by density centrifugation, perform D typing and auto control using retic-rich cells. 4) If the patient is DAT positive, perform EGA or CDP treatment, test EGA, CDP treated cells with plasma and eluate. 5) Lastly, test plasma and/or eluate (wherever you are seeing anti-D) with DTT-treated red cells and cord cells to exclude or confirm anti-LW. Please let me know if there is anything else to add to this list. Hope this is helpful.

I just answered this question. My Score PASS

After a lot of reading and deliberation, here is what we ended with. Testing of Male Patients and Female Patients ≥ 56 Interpret according to Rh Tube Test SOP. Follow discrepancies as outlined for women below, except for sending for molecular testing. Testing of Female Patients < 56 For newly tested women less than 56, if result is 0, testing is complete. If > 0 but < 2+, interpret as Rh neg and perform Rh molecular testing. Notify a supervisor to have molecular testing performed. If ≥ 2+, interpret as Rh pos. This is for all women less than 56, not just OB patients. Discrepancy Resolution What is a discrepancy? Let’s keep it simple. Regardless of what methodology was used for their previous type, if it was interpreted differently than the SOP says to interpret it now, it’s discrepant. If we get conflicting info from an outside facility, or the patient themselves, it’s discrepant. Discrepant is defined as: Rh pos when previously resulted as Rh neg, or Rh neg when previously resulted as Rh pos (at BWH, at any other institution, or per patient history.). For Male Patients and Female Patients ≥ 56, follow the Rh Discrepancies chart in Rh Tube Test SOP. For women < 56 with a discrepant result, interpret as Rh Neg. Notify a supervisor to have molecular testing performed.

It was a bit of a troll question. It seemed to me that if we can't trust the reactions we get in gel then what's the point of using it. As far as I can tell regarding the IFU's Dansket is right. I realize the importance of precision and care being taken in the blood bank, but I think a lot of times we fall victim to an overabundance of undue caution.

Excellent, and thank you. Very helpful. Here was my takeaway: Therefore, we recommend that samples yielding an IS tube test cutoff score of not more than 5 (i.e., ≤1+ hemagglutination) or a score of not more than 8 (i.e.≤2+ hemagglutination) by gel technology, be considered D– for the purpose of transfusion and Rh immune globulin prophylaxis.

I suppose if you are dealing with a cold-M (with positive reactions in gel) that you later successfully warm-away with tube testing, you could consider the antibody screen negative, when technically you would have a positive gel screen to begin with. But this is not the same as reporting a "positive" screen as negative! Scott

NO! I am a professional blood group sereologist!

Please help PathLabTalk to grow. We now have a referral system so we can see who has referred the most members to the site. Why would we want to track such a thing? Easy, we're doing it as part of a contest. Whomever refers the most people to the site (a minimum of 10 people) by January 31, 2017, will win a fitness tracker of their choice, up to a $200 value! So, just how do you do this?, it's really simple. Go here then copy the Referrer URL. Send that link to all of your friends and coworkers. When they join, your name will automatically be filled in as the referrer in the registration form. The main page of this site will list the top referrers so you can track your progress. Please help us grow!