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Maternal alloantibody, not detected in baby - how long for antigen negative units
Yes - she is African-American - the anti-N is pretty well established in her case to be an alloantibody - she's had it for awhile. I recognize in this case, that an anti-N is more than likely non-significant, so I was less worried about any issues here. I guess my REAL question is how long do you keep providing antigen negative units, particularly when the baby's antibody screen is negative? The way our policy reads right now is vague - but has been interpreted as basically until 4 months of age, which seems long to me!
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Maternal alloantibody, not detected in baby - how long for antigen negative units
In this case, it’s an anti-N, but I would have the same question (and potentially more important to answer) if this was an Rh, K, or other “more often significant” antibody. For clarity: mom: positive screen at referring hospital (we don’t have L&D) - anti N identified baby: got some blood at birth NICU, transferred to us. We get the record of anti-N from outside. Our tests show: baby negative ab screen, baby negative DAT We didn’t have anti-N reagent to antigen type baby (plus they had been transfused). I don’t remember precisely the hemoglobin, but it was in a range appropriate for transfusion - baby had undergone a few procedures with blood loss. There was very low suspicion for ongoing hemolysis and prenatal course had been okay - mom had been monitored by high risk MFM OB due to the antibody, but no intrauterine transfusions had been needed.
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Maternal alloantibody, not detected in baby - how long for antigen negative units
I'm a little newer to the blood bank, so often need help understanding / reconciling our current policies - appreciate any help or insights (or references!) Situation: Mother has known alloantibody (a potentially clinically significant one). Baby is born and our testing shows negative antibody screen. Our current policy requires antigen-negative units for transfusion (with resultant AHG crossmatch) if maternal alloantibodies are present, but it doesn't say HOW LONG we need to give those antigen negative units. Questions: Is the use of the antigen negative units in this neonate with no detectable antibodies (negative screen) because of the possibility of "missing" low titers of maternal antibodies in baby? [I'm having trouble finding the REASON for this practice] Am I correct in thinking that we could antigen type the neonate, and if we prove they lack the antigen in question then we could drop the requirement. [the baby in the actual case that brought this up had been transfused at the birth hospital, so we didn't attempt this] How long does this antigen-negative requirement stand? Right now, our policy is being interpreted as lasting until the baby is 4 months old, but I really am not sure where that came from.
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Question about PT on RapidPoint and iStat
I am in a small lab where we currently do blood gases on a RapidPoint. We will be bringing up one iStat in our ICU, and I'm confused about profiency testing. Per the 2015 CMS directive, we "are not permitted to test PT samples on multiple instruments unless that is how they routinely test patient specimens." In reading through CAP literature though, it is permitted to use two PT products that are totally different but test for the same analytes.---the example given is evaluating chemistries on a traditional analyzer and an iSTAT, since those results would not be comparable. So my confusion arises from the fact that I have two aqueous blood gas instruments. Do I name one primary and just do PT on that one, then compare? Or is the iSTAT so different that I should run PT separately on both. (Of note, in the CAP catalog, you have to order different PT material for iStat versus non-iStat).
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Glad to find ya'll
I just joined the group! Found you all through Google! I'm a pathologist in the central US, and learning quickly about lab operations. Glad to be here!