Leaderboard

We did not. Units were kept refrigerated until they were ready to into the irradiator. We documented the time that the unit went into the irradiator and the time it came out. Electronic component prep was done immediately. If this was not possible, the units were placed back in the fridge until it could be done. I don't know what is the current checklist because I retire a year and a half ago.

This phenomenon is also described with the monoclonal antibody therapy anti-CD47 (Hu5F9-G4) where red cells are so heavily loaded with IgG that it creates steric hindrance. Basically, antibodies bound to the red cells hinder the binding sites of the anti-human globulin leading from very weak to negative DAT. Anti-CD47 can be eluted off the red cells and it gives very strong reaction in IAT. Of note: it is not the same mechanism involved with the anti-CD38 (another monoclonal antibody therapy often called DARA) where here the DAT can be negative too because of down-regulation of CD38 expression onto the red cell membrane.

Most certainly it can. There have been published papers on newborn babies being typed as D Negative, and K Negative, not because they have received an IUT, but because their mother's antibody has such a high titre that they sensitise virtually every antigen site on the cord red cells, thus causing a sort of prozone effect. The same can happen with a "blocking antibody" and AHG. It is also not uncommon for newborn babies with ABO HDFN to have a negative DAT, and be released from hospital, only to be brought in again when they become "floppy", and for the DAT to then be positive.