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Thanks, Malcolm. Signing up now.

Yes indeed different pH, different suppliers may explain such a behavior (some anti-M are enhanced with acidification of plasma). In addition, Anti-M often shows dosage effect but I believe you have antigen M double dose cells on your panel too. What are the phenotype of the 2 cells reacting in screening and the one not reacting? Is your patient antigen M negative? It also exists the anti-M1 (the M1 antigen belongs to the MN CHO collection) that reacts with some M positive cells and stronger with M/N positive cells (M1 is expressed on M positive cells) and it can be, though rarely, produced by antigen M positive patients.

We are using HCPCS code P9107.

Would suggest using only ABO identical plasma. ABO mismatched plasma creates soluble immune complexes that, at least in vitro, damage endothelial cells, impair platelet function and cause dysfunction in the coagulation cascade (thrombin generation). Probably not a good thing in patients who already have these problems ongoing.