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Showing content with the highest reputation on 05/01/2020 in all areas

  1. jojo808

    Need Help

    So we did perform the tried and true tube method with Peg enhancement (actually our secondary method) and both units came out a clean negative. The MD wanted to transfuse only one unit and see how the patient does. I'm so ok with doing that. I will try and keep you all posted thank you all again.
    3 points
  2. exlimey

    Need Help

    I like your "neo-science" quote ! As the actual science has progressed, and the sensitivity of assays has increased, workers have encountered "-only" antibodies: albumin-only, enzyme-only, LISS-only, PEG-only, solid-phase-only, Gel-only. As you point out, if the older assays were that bad, we'd have patients dropping all over the place due to the presence of "missed" antibodies and false-negative crossmatches. My point about the "stickiness" is that the gel system is notoriously unforgiving with anything but completely normal, healthy, well-washed cells, preferably in the manufacturer's diluent. Throw anything at it that's little different and you risk incomplete or unsatisfactory centrifugation of red cells. I don't know if that specifically happens with Jk(a-b-) cells, but I have seen frozen/thawed cells behave badly. After reviewing the posts here , I think it's perhaps a little more worrying that jojo808's group may consider transfusion of "least-incompatible". I understand that needs must, but that's a dangerous proposition if one doesn't know the specificity of the antibody(ies) causing the incompatibility.
    1 point
  3. Malcolm Needs

    Need Help

    exlimey, I would most certainly agree with your first comment. In the VERY old days, when I was merely middle aged, and we only had access to tube tests and reagents, including AHG, and techniques (such as tile techniques), we didn't kill patients by the thousand, so techniques that are a little less sensitive than are available these days, will not necessarily condemn the patient to a certain and painful death, despite the deafening shouts of those who are gainfully (and, in many cases, VERY gainfully) employed within the neo-science of quality for quality's sake (we needed to pull up our socks in terms of quality, but it has got out of hand). On the other hand, having seen a fair smattering of Jk(a-b-) patients with anti-Jk3, I am unaware of "sticky" Jk(a-b-) red cells, even when they have been cryopreserved and reconstituted. I am willing to, and will freely admit to being wrong, if I am proved so.
    1 point
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