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i stopped buying lewis antisera years ago. No sense.

Yes, it makes me sad to throw away the remainder of the unit. But....the filter syringes have to be purchased by the case, which for us would be a near life-time supply and they are expensive to throw away every couple of years when almost all of them would be outdated. You have to demonstrate competency yearly for preparing aliquots and I don't know how you would do that without sacrificing units, plus for me to access competency when I would barely know what to do would be a joke. We would have to pay for the appropriate licensing yearly to relabel the syringes once split. We would have to have something like Digitrax set up and validated for use once or twice a year, because we don't need to relabel anything else. Our blood center is 150 miles away so its not feasible to order blood in pedi-packs for urgent need. I don't feel that stocking units like that for use once or twice a year makes good sense. I doubt that our supply would agree to do it anyway. My BB LIS isn't set up to receive or use splits, so more validation. Once I split the unit, the remainder of the unit would have to be transfused within 24 hours because we don't have sterile docking capability - more money, more competencies. We do actually have a day now and then when no one is transfused, so the remaining part of the unit might still be wasted. I've run this scenario through my head multiple times and I've never come up with a better option than handing over an entire unit to be used as the provider requires. Still makes me sad to discard the unit.

This is the plan we use for the 1 -2 units we transfuse to infants each year.

In the UK, we give cross-match compatible blood in both situations. NHSBT do not give out typed blood for Lewis antibodies.

For both situations we would give IAT and immediate spin crossmatch compatible blood, would not worry about finding antigen negative units.