Leaderboard

I only wish I could know another language anywhere near as well as Yanxia knows English! She has always impressed me with her blood bank knowledge as well.

I'm all for the concept of quality and the strive to provide the safest blood products to patients, but I won't deny that sometimes many of our current practices in blood banking in terms of achieving that "quality" seems excessive, unnecessary, and sometimes it feels like a mere quality charade for inspectors and regulators. Considering the hight cost that blood banks have to incur to meet all quality regulations, it may be worth studying the financial impact of the many quality measures that regulate the practice of blood banking and to what extent these measures are actually contributing to achieving the quality needed to provide the best blood products to patients.

Not in a blood collection center, so no policy. But scientifically there is no rationale for donor deferment. The vaccines are not live/attenuated but rather just protein with no potentially infectious material of concern to recipients. The virus, in any case, should only infect respiratory mucosa and thus would represent minimal to no risk to recipients even if present in donor blood (similar to coronavirus and influenza).

Blood bank methods aren't expected to correlate perfectly. We use their differences to avoid rouleaux, clinically insignificant, and weak warm auto reactivity so we can better detect any significant alloantibodies. No method will detect 100% of significant antibodies. I am going to tweak the above to say we can "better detect' antibodies so it works better with the next sentence and doesn't imply that we can detect "any" significant antibodies.

I could be wrong on this.....but I don't think the FDA would go to the other facility.......... We have several "sister facilities" that we send blood to for storage that are in our system and another facility that is not in our system. When we get inspected, they don't go there..... We are FDA registered because we irradiate and wash/deglycerolize units....ie - "create" products. I think they just have to comply with CAP and or AABB standards for storage.

🩸 Master Transfusion Reaction Management! 🩸 🎯 Objective: join this upcoming intermediate-level webinar. It's a chance to equip yourself with crucial skills for recognizing and effectively managing transfusion reactions. 📚 Prerequisite: No prior knowledge is necessary. We recommend checking the free Transfusion Reactions E-learning Module, accessible in both English and Spanish on the ISBT website. 🎓 Target Audience: This webinar is suitable for healthcare professionals engaged in patient care, blood product administration, and preparation. 🎙️ Featured Speakers: 👨‍⚕️ Richard R. Gammon - Chair, Clinical Transfusion Working Party Education Subgroup, Medical Director at OneBlood, USA. 👨‍⚕️ Divjot Singh Lamba - Co-Chair, Clinical Transfusion Working Party Education Subgroup, PGIMER, Chandigarh, India. Don't miss this incredible opportunity to enhance your skills . Register now and let's learn together! 🚀 https://immunohematologymadeeasy.com/isbt-webinar-transfusion-reactions-a-z/

The response I got from ARC is that it is up to our medical director. There is no FDA exception needed, as the FDA doesn't have a regulation on shipping duration or transit time. They only care about temp, and since the temps are in range, there is nothing to seek a variance from. I heard from people who use other blood suppliers, and the general consensus is that if the packing is correct, ice is still present and the units are in temp range, they are acceptable, as long as there is documentation of this deviation from the hospital's normal policy. I ended up adding this tidbit to my SOP as an allowed deviation by our medical director, just need to fill out the deviation documentation form and have him sign, but this way, we can accept the units in immediately and not delay having them be available. Especially important for platelets!

Dive into the Future of Transfusions: Molecular Blood Group Typing 🩸🧬 The guest speaker is Dr. Meghan Delaney, DO, MPH, holding prestigious positions: Assistant Professor at the University of Washington Medical Director at the Puget Sound Blood Center Medical Director of the Blood Bank at Seattle Children’s Hospital 🔍 Here's a sneak peek into the topics we'll explore: Real-life case studies revealing transfusion challenges 🩺 How Red Cell Genotyping is changing the game in safety and accuracy 🩸 Deciphering the genetic complexities of Rh Blood Groups 🧬 Unraveling the importance of C&E Alleles in blood typing 🅰️ Ensuring Transfusion Safety in a diverse landscape 🩹 The ripple effect of mismatched transfusions and its implications 🤯 The exciting prospects of Hybrid Alleles in the realm of Personalized Medicine 🔮 Stay tuned for exciting developments in healthcare! 🚀y Let's dive deep into the future together. 🌊💉 https://immunohematologymadeeasy.com/red-blood-cell-genotyping-for-improved-medical-care-meghan-delaney/

Some references related to the Platelet Glycoprotein, GPIV B. R. Curtis, J. G. McFarland. Human platelet antigens – 2013. Vox Sang 2013;106:93-102 Curtis BR, Ali S, Glazier AM, et al.: Isoimmunization against CD36 (glycoprotein IV): description of four cases of neonatal isoimmune thrombocytopenia and brief review of the literature. Transfusion 2002; 42: 1173–1179 Ikeda H, Mitani T, Ohnuma M, et al.: A new platelet-specific antigen, Naka, involved in the refractoriness of HLA-matched platelet transfusion. Vox Sang 1989; 57: 213–217 Curtis B, McFarland J: Detection and identification of platelet antibodies and antigens in the clinical laboratory. Immunohematol 2009; 25: 125–135

ISBT has an excellent podcast I have been listening too. You can listen and subscribe here:https://www.isbtweb.org/resource/announcing-our-new-podcast-transfusion-practitioners-across-the-world.html

We issue uncrossmatched units in our BBIS, so it prints tags for the units that resemble those for crossmatched units. Fast, easy and accurate plus the RNs can scan the units in Epic to document transfusion. We use SafeTraceTx. We have a downtime uncrossmatched blood form we can complete on paper. We keep a photocopy. See attached. Emergency Release of Blood Products (form) (20553_0).pdf

I would thoroughly recommend that you contact Rachel Moss Hibbttt at Imperial College Healthcare NHS Trust.

I didn't find much either, but from what I did find it looks like it could be another interesting blood banker's problem since CD36 is definitely found on RBCs. And it sure looks like it may be utilized with immunotherapy for multiple kinds of cancer treatment to make it more effective. Or for FNAIT. https://pubmed.ncbi.nlm.nih.gov/1382721/ The link below is interesting - not sure how it would relate. https://pubmed.ncbi.nlm.nih.gov/8623134/ And then there are these tidbits: https://pubmed.ncbi.nlm.nih.gov/34041523/ https://www.ahajournals.org/doi/full/10.1161/01.atv.16.7.883 If patients with African descent are more likely to develop anti-CD36 due to CD36 deficiency, are their red cell ABO types (or other antigen types) going to be affected by that antibody (which would be an autoantibody)??? I'm with Mabel - anyone out there know anything about using anti-CD36 for cancer treatment or FNAIT treatment?

Our Red Cross just informed us that it will discontinue providing CPDA-1 rbc. We primarily used it to provide volume reduced red cells to pediatric patients under 3 years of age. We will volume reduce AS-1 or AS-3 by centrifugation or washing (Terumo 2991) instead. Probably unnecessary for most patients, but this is a long standing practice here, and it doesn't seem worthwhile trying to adjust pediatric practice in this regard. Most patients do not need the additional volume provided by the anticoagulant-preservative in AS-1, etc., and avoiding unnecessary volume is a reasonable goal in many patients. There is no inherent virtue to CPDA-1 vs. AS-1 and similar solutions, and rbc preservation is slightly better in AS-1/AS-3 by in vitro metrics. There is absolutely no factual basis for using CPD-A1 in preference to AS-1, etc. in pediatrics. Purely expert opinion and probably unduly conservative. I've attached a nice presentation by Dr. Saifee at the University of Washington, who createdAdditive solution AS-1 in Children Univ. Washington presentation Dec 2021.pptx it to educate her colleagues about using AS-1 instead of CPDA-1. Additive solution AS-1 in Children Univ. Washington presentation Dec 2021.pptx Pediatric RBC White Paper - November 2021.pdf

If you will be getting any of those units back then a FDA inspector may want to see their storage records. Some will, some won't, depends on the inspector. Better to be prepared for the one that wants to see them. In this case a little paranoia may be a good thing.

I just answered this question. My Score PASS  

I just answered this question. My Score PASS  

I just answered this question. My Score PASS  

I would like to see studies as to why transfusion services continue to provide ABO non-identical transfusions when they have ABO identical components in stock. ABO mismatched red cells (so-called universal donor group O red cells), platelets and plasma (so-called universal donor AB plasma) have all been associated in randomized trials (platelets) and observational studies (red cells and plasma) with increased mortality, bleeding and other dire complications. Why has an entire specialty failed to take notice of data that contradict long standing dogma? What can be done to improve this performance and reduce suffering, morbidity and mortality amongst our patients? This is particularly important because ABO non-identical platelets may actually make hemostasis worse, and thus no transfusion is likely better than an ABO non-identical platelet transfusion, as one example.

Welcome to this wonderful site NewbieBB. Enjoy it!

AABB standard allows for no agitation for up to 30 hours

🩸🔬 Exploring the Intriguing Universe of Blood Group Antigens! 🌐 🔍 Let's delve into the fascinating details: 44 systems, 354 antigens sculpted by 49 genes, all meticulously documented by ISBT. 📚 Join the journey on Systems, Antigens, and Alleles to unravel the complexity. 🔬 Decode ISBT's enigma: Discover 'Collections' (200), delve into rare (700 series <1%), and common (901 series >90%) antigens. 🧠 Gain mastery over the precise terminology and venture deeper into the realm of Immunogenetics. Embark with us on this quest through antigens, genes, and the rich tapestry of human diversity! https://immunohematologymadeeasy.com/red-cell-immunogenetics-and-blood-group-terminology/

My Chinese is a bit rusty, but if I am not mistaken, the underlined sentence states that we need to wash cord blood at least once before testing. Sorry, I am just kidding, I don't know any Chinese, I just read Yan's explanation.

Ortho MTS gel instructions say to wash if there is interference from clots, which may happen with cord blood, but it doesn't say to always wash cord cells before running a gel DAT.

Sorry,I can't find the English version.The underlined sentence means the cord blood cells needed to be washed at least once before testing.

I'm afraid I still can't agree with this methodology, for a couple of reasons. Firstly, antibody/antigen reactions are, largely, governed by the Law of Mass Action. As a result, and given a steady state of conditions (e.g. temperature), however long the incubation time may be, once a state of equilibrium is reached, there will be no net gain of antibody coating antigens, however long the incubation time may be extended. Certainly, LISS will increase the rate of association of antibody and antigen enormously, but this will apply equally to the auto-antibody as any allo-antibody that may be present, however, of course, some antibodies will only react visibly with red cells that have homozygous expression of a particular antigen, and, if such an antibody is present, it will be very difficult to detect in the presence of an auto-antibody, but can still cause a haemolytic transfusion reaction, albeit, usually a delayed reaction, but it can still cause damage to the renal system in particular. For these reason, I would always perform an adsorption, to get rid of the auto-antibody, even if I had no intention of performing specificity tests on the auto-antibody (although, it goes without saying, I would go all out to try to ascertain the specificity of any allo-antibody detected). I am trying to write a book at the moment, called "Human Red Cell Serology and Blood Groups for Beginners", and Chapter 2 deals with Serological Techniques. I attach the draft copy, which also gives relevant references, the odd diagram and abbreviations I use throughout the various chapters. Chapter 2 Serological Techniques in Routine Blood Transfusion and Red Cell Immunohaematology Laboratories.docx Chapter 2 Serological Techniques in Routine Blood Transfusion and Red Cell Immunohaematology Laboratories Figures.docx Abbreviations.docx

I've had further thoughts upon this case (having told you not to worry about it - I live a sad life - NOT!). It struck me that the patient has an Rh type of D+ C+ c+ E+ and e+, suggesting that the probability is that the patient has a genotype of DCe/DcE (R1R2), but this may not be the case. She could have one of the rarer Rh genotypes, such as DCE/Dce (RzRo), DCE/dce (Rzr), Dce/dCE (Rory), etc, and this may be potentially important. Some years ago, Joyce Poole explained to me that most grouping reagents labelled as anti-C are, in fact, a mixture of anti-c and anti-Ce, and this, she told me, included most monoclonal anti-C reagents (which surprised me, to be honest). This is because the vast majority of the red cells transfused that stimulate an anti-C would have the haplotype of either DCe or dCe, or both, and will, therefore, also stimulate an anti-Ce. As a result, these "hybrid" anti-C/anti-Ce reagents will react more strongly with red cells expressing the Ce compound Rh antigen (Rh7) and the C antigen (Rh2), than with red cells that only express the C (Rh2) antigen. This would not, incidentally, explain the stronger than normal reaction with the e antigen. However, if the patient does express one of the rarer Rh types mentioned above, say she is RzRo, she can actually produce an allo-anti-Ce, and most antibody panels only contain C+ red cells that are only Ce+ as well. In other words, her antibody in the plasma MAY be identified as an anti-C, whereas it is actually a monospecific anti-Ce, which would neatly explain why she has an apparent anti-C. Of course, she may also have an auto-anti-C, or a mimicking auto-anti-C (and, possibly, an allo-anti-Bg of some sort). Sadly, for a nerd like me, I doubt if we will ever know! I think it was John C Staley who once accused me of looking for zebras, when I hear horses hooves (I may be wrong, but I think it was John). Anyway, this proves that he was absolutely correct about me!!!!!!!!!!!!!!!!!!!!!!!!

My manager and myself (asst manager) both complete the same competency that the staff do in order to be able to be able to fill in at the bench if the need arises. "This year's" competency is "good" for next year's observations. It's hard to get done - but, we both feel it's valuable - and the staff seems to appreciate that we remain "competent" since previous management had no clue what went on at the bench.... Keeps us in the loop.

Building Soft to join with Epic at the moment. I have the same issues mentioned above. The traceability work arounds are a huge issue for us. Epic allows for "Other collector" and it will time out and autofill the collect time as the current time instead of forcing an entered result that will match the written time on the tube. I feel comfortable with the WBIT being minimize, but since the tracking to phleb ID and correct collect time is an issue I am requiring a second tube for compliance sake. We are dropping blood bands with the Soft go live because the security features added to BPAM are leaps beyond what we currently have. Blood bands at current have only caused problems and patient delays, never stopped a patient ID issue.

It's a state law issue. Each state sets its own regulations about who can order what, if I recall correctly. It sometimes may be an institutional issue.

nurse practioners and pas can order blood components. At least any place I've ever worked.

For those of who works in transfusion service laboratory and would like to learn more reference cases, I can post some mock-up cases here. If you would like me to do it, please hit the "heart" button on this post. If enough folks want to practice case studies on reference lab cases, I can post mock-up cases here weekly or so..

Getting your SBB is great knowledge to have, and I agree with Cliff that it will open more doors for you to do other things. Having worked in large busy trauma center BB's for 17 years now, I can tell you that my SBB knowledge rarely comes into play in a hospital BB, unless you have ALL the things (complex antibodies, washing/irradiating product, neonatal population, ref lab for system hospitals etc). If you have goals of Ref Lab or a private company, many of them require an SBB. You can also get in with a teaching program with an SBB easier than without. I've heard many hospital labs would like to have their admin directors be blood bankers with an SBB, as it brings a quality eye that other candidates don't have, but it seems rare to find those people because so few of us want to do that job! As far as helping you run your blood bank, it likely won't be that beneficial, as most of the curriculum is a deep dive into antibody qualities and rare things, but there is some info on supervisory duties and such. I graduated from LifeShare's SBB online program in 2019, after having worked in the BB for 10+ years. I personally liked the online program, as I already was the supervisor of the BB at the time, had two small kids and was not able to move across country to attend a program in person. LifeShare and UTMB share their curriculum, and an SBB from LifeShare is eligible to go on to the Masters in Trans. Med from UTMB should you wish to do that. Katrina Billingsley is the director of the program at LifeShare, and she is fabulous; would highly recommend her program.

We have had HFAP until they were purchased by ACHC, and both of those have cited me for the lack of correlations: one for not performing them at all, although I pointed out that we do that on every specimen without previous records, and just last year because I didn't include crossmatch tests with my Type and Screen correlations. I contested the citation again, stating that it was the exact same methodology as the antibody screen, but was unsuccessful as their standards say "the same test using different methodologies ". I gave up and added XM as well. No concept of what we do and no common sense!