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Tests on the adsorbed serum (with ZZAP-treated cells) give confidence that the are no underlying alloantibodies to common antigens. However, the use of allogeneic cells risks removal of a cold-reactive alloantibody to a high incidence antigen, e.g. anti-Vel, -PP1pK. A low risk, but still concerning. Does you facility also test the ZZAP-treated patient cells (now presumably DAT-negative) back against the patient's own serum ? This is ultimate proof that the cold-reactive antibody is an AUTOantibody and adds more confidence in the results of the adsorption with allogenic cells. I may be opening a can of worms here, but.....I question the use of ZZAP in this scenario. In this case, the adsorption used (presumably DAT-negative) allogenic cells. ZZAP was not required to "reduce the DAT and enhance antibody uptake" - which is a true statement about performing AUTOadsorptions with DAT-positive cells. I appreciate that the enzyme in ZZAP enhances the efficiency of the adsorption, but the DTT component is not necessary for most alloadsorptions, and can actually confuse the users. I suspect the answer/policy is related to ZZAP being commercially available, rather than in a well-founded technical reason.

My personal system was virtually identical to yours except for the the reverse type I used JH-RA and JH-RB. In the facilities where I was the Transfusion Service or Blood Bank supervisor my tube labeling requirement for the staff was that anyone in the department could set down an take over the testing and know who and what was in each tube.

Yes.

If you are talking about tube tests, I label A,B,D,Dct, a,b. ABSC: 1, 2, 3. With the pt initials underneath.

I validated anti-C3b,-C3d using buffered gel cards. We use 0.8% patient cells and we make the commercial Complement Check cells 0.8% too. We spin after a 5 minute incubation at room temperature. The check cells are always 3-4+. As for the sensitivity problems being discussed - negative tube vs + gel . . . why are you using gel? Up front we all know it is more sensitive. I don't think you can ignore a + gel result just because you repeat it in tubes and it is negative. My ped docs are enthralled with the increased DAT sensitivity. I have found 3 anti-Jka in gel that were negative with tube/PeG testing. Are they clinically significant? I can't ignore them.