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In which buffer do you resuspend your DTT treated cells? May be these patients do have antibodies against one or several components of this buffer (antibodies against preservatives used in RBC buffer are not so uncommon).

Since all elective surgeries have been postponed and restaurants/bars have closed the BB has been incredibly slow which is rather scary in itself (the calm before the storm?). Due to this we have voluntary reduced our inventory to help with the blood supply.

Hi Rich, I am not a clinician but as far as I know IVIG can be given to obstetrical patient in diff. conditions (autoimmune disorders, recurrent pregnancy loss, ...). I thought about IVIG when I saw the DAT becoming positive plus additional reactions coming up over the time. Anti-A and Anti-B are indeed the most prevalent antibodies in plasma derived products but other specificities of low titre can be present sometimes such as anti-D, anti-K and a bunch of antibodies of undetermined specificity reacting with several to not say all RBCs. Just a thought that can be doublechecked with the clinician..? Hereunder is a very great (not recent though) paper to be read and re-read again: Problems Associated With Passively Transfused Blood Group Alloantibodies George Garratty, PhD, FRCPath American Journal of Clinical Pathology, Volume 109, Issue 6, 1 June 1998, Pages 769–777, https://doi.org/10.1093/ajcp/109.6.769

We've been in short supply of RBC's and platelets for so long now it's going to be hard to notice. One good thing that has come of it is the intensified scrutiny of every order - providers have been made keenly aware and are re-evaluating their ordering practices. I guess necessity is the godfather of compliance.

Alloasorption. In fact, having worked in Reference Laboratories for most of my life, it was VERY unusual for the patient either to have NOT have a transfusion within the previous three months - meaning that they were not a candidate for auto-adsorptions - or their haematocrit is so low that there are too few autologous red cells to perform an auto-adsorption in the first place (usually because they were sent to us because they needed a transfusion in the first place!).

We keep them until the monthly invoice comes and then they are discarded. All documentation of unit receipt and final disposition is in the computer system.

The other thing you have to remember is that the charges are not for the blood itself, but for the processing needed to provide the blood. These charges are the same regardless of how much of the unit is actually administered.