[Add on units on current Type and Screen]

37 minutes ago, Teristella said:

We use Meditech and the units are automatically added to the most recent, current blood bank specimen. In this case it would be a current type and screen.

We do not repeat type and screens if it is a new provider, as the provider is recorded in Meditech.

Teristella, this sounds great, do you know where Meditech is set up for that parameter?

[Add on units on current Type and Screen]

Question:

How do you proceed when a provider is adding units on a specimen from a different date (<3 days) in your LIS (I use Meditech)?

I am a little confused about this issue, some techs at our lab add on units to the original specimen, others redo a TS and crossmatch on new order... specially if it is a different provider who ordered the crossmatch vs TS.

And is there any CMS or other billing reg about this situation?

Thank you all in advance for your help!

Helen

[0.8 Surgiscreen, vial # 2 reactions]

I experienced this situation a few times (I think one is too many!) where the DAT is positive (gel IgG). This is why as soon as we receive a new lot, I perform lot to lot comparison. If there is an issue, I call right away Ortho and they ship me overnight stat a different lot # free of charge for us.

I know a few labs switched to 3-5% Biorad cells and make their own 0.8% daily suspension. I am thinking about it, but I do have other fish to fry for the moment!

Helen

[Storage of crossmatched vs non-crossmatched units]

Wondering if there are any regulations about storing crossmatched vs non-crossmatched units of red blood cells on the same shelf.

Also, do you store different blood types (ie A pos and A neg) on the same shelf as well?

Thanks,

Helen

[Meditech 5.67-Where to begin?]

Hi! I just started in a new blood bank, and Meditech is a .... mess!

The blood types are not calculating, I need to add a D control result line because we are using manual gel, remove the Anti-AB and many many other issues that need to be fixed. I worked with BB Meditech for a while, but not the building and changing calculations. I am trying to have Meditech help me, but after a week, I am still trying to reach someone (I heard that their customer service is bad...).

I would like to get my hands on a manual or web site on how the calculations work. Do you have any ideas?

At this point, I am very frustrated!

Helen

[A positive with ? anti-A1]

Hi everyone!

I have an OB patient (first semester of pregnancy) who has a history of A positive, 3 previous pregnancies, who is puzzling me and I would appreciate your input. My results are:

In gel,

Anti-A 4+

Anti-B 0

Anti-D 4+

Ctl 0

A1 cells IS (no RT inc.) w+, 15 min RT inc. 3+

A2 cells 0

B cells 4+

In tube, I have a weak A1 microscopic (and no rouleaux). A1 lectin is negative (weak pos micro, which the package insert says that a weak pos should be considered negative). 

Antibody screen negative at 37 C and RT. I ruled out P1 and M with gel.

Is the patient really A with anti-A1 IGM? I am just concerned because she is pregnant, I want to make sure that there is not something I am forgetting...

Thanks in advance,

Helen

[Bone Marrow Transplant]

Thanks for that BloodBankGuy.

 

The reason I asked was because if, say, a group A Secretor is transplanted with a group O donor, the chances are that the recipient may never make an anti-A (although they may make an anti-A₁).

 

I am probably "teaching my grandmother to suck eggs", but this is because the recipient will continue to produce Type 1 (soluble) A antigen.  This Type 1 antigen can adsorb onto the group O red cells (although this may only be detectable by very sensitive elution techniques), but can also interfere with the production of anti-A, either by inhibition of any anti-A that may be produced, or by immune tolerance (or both, of course) - see my first ever publication - Needs ME, McCarthy DM, Barrett J.  ABH and Lewis antigen and antibody expression after bone marrow transplantation.  Acta Haematologica 1987; 78: 13-16 - and apologies for the ego trip!!!!!!!!!!!!!!

I just experiencied this today: Patient has a history of B pos, BM transplant in july 2014 from an A pos donor, it is now A pos without any reaction with A1 cells and B cells. I transfused O pos units (Invalid ABO type in Meditech), but my question is that patient will ever have anti-B in her plasma? Should I keep giving her O pos and AB plasma forever?

Thanks, Helen

[Antibody ID Policy/Process/Procedure]

Thank you to everyone who messaged me. If anyone else is willing to send I'm always willing to read. Please feel free to PM me.

I would be curious to read yours Goodchild, I am just starting a new supervisor role and there is no SOP for QC, MTP, AB ID... so I have a lot of work to do!

[Mini Panel/Screen for Patients Who Were Given Rhogam]

What about C, E and K that you are not able to rule homozygously? Most patients that are Rh negative are also C and E negative and there is the possibility of another antibody other than the anti-D due to Rhogam, and in the case of a pregant woman, that could cause a HDFN.

Any thoughts on this?

[Immediate spin crossmatch]

Hi everyone!

This might sounds like an odd questions, knowing that some of you have already upgraded to the electronic crossmatch, but our pathologist is very conservative and I am just starting a new BB supervisor in NY state. So we currently perform IgG gel crossmatch on all crossmatches, and NO immediate spin. I convinced the pathologist do perform IgG xm only on patients with current or previous history of antibody and to do IS on all crossmatches, but she wants them done in gel, but by reading the IFU, it doesn't seem to apply "This MTS™ Buffered Gel Card can be used in ABO Serum Grouping as well as direct agglutination i.e., cold and warm antibody detection." . I know it would be so much easier for the staff to do tube IS, but she wants to stay away from tube, ie reading interpretation errors.

Anyone is currently using Ortho gel buffer cards for IS? Is the Vision do IS crossmatch?

Thanks,

Helen