Kandahlawi

We know that Malcolm - I was using the terminology that was existing at the time when Du was being used AND that we did not give RhIg to Du+ individuals then.  Besides, whoever heard of anti-Du (not me)?
Was it always Weak D in Great Britain?
Aside from the Pedantics, what is your take on RhIg for Weak D individuals?  I do not routinely perform Weak D testing on maternity patients.

Sorry, but I am going to don my PEDANTIC hat again.  There is no such thing as an individual (male or female) who is Du+.  There cannot be, as there is no such thing as anti-Du.  When Dr Fred Stratton first described "Du", he, together with Drs Rob Race and Ruth Sanger tried to separate anti-D from anti-Du, and vice versa, and, of course, they could not so do, as anti-D was adsorbed out by Du red cells and this proved that anti-Du did not (and still does not) exist.

What size tubes do you use?
Is the red cell suspension made from whole blood or packed cells?
Do you leave the plasma on the red cells in one tube during and storage?
 
Thanks!
 

I haven't contributed to this thread, for the simple reason that I have no idea how someone (patient or donor) can be weak D positive.  Sadly, in my laboratory, and, I believe, in my country, we do not have any anti-weak-D.

We don't take the unit back.  If they call us because the unit has been issued and the IV is not working, we ask if they can transfuse it within 4 hours of issue.  We make them keep it with them.  If they can't get it transfused within 4 hours we would discard it.

Thank you David for your feedback.  My thoughts exactly.  Unit warms to >10 anyway and the transfusion will be competed by 4 hours from original dispense.  My pathologist heard at a conference that we should not be taking back units >10 even if we will dispense to same patient and complying with the 4 hours rule.  Can' t get her on board with it.  We've now changed our policy to throw the unit away.  Thankfully it doesn't happen very often!  I've also just been through a CAP inspection with this policy in place and no deficiencies found.

I do this.  It only makes sense.  AND it was part and parcel of AABB a few years ago. (maybe more than a few).  The unit was going to hang and get >10C anyway.  The product is not going to be any more deleterious than if it was hanging.  Besides, the stuff is too precious to discard.  I have not had my policy challenged since it was written back in the late 1990's - at least 8 CAP inspections and also FDA.  I believe the original criteria documenting this was in the Accreditation Requirements Manual

In the US, we use metrics in the lab - Celsius, grams, milliliters, centimeters, etc.  The 'outside world' uses Fahrenheit, pounds, cups, feet, etc. ... even nurses and MDs!  It would be nice to go metric 'out there', too!

I see discussions about the 30 min or 10 degree dilemma, but not this particular issue.  I'm not talking about if the unit has been spiked, this it is definitely discarded.  If the unit is issued to the floor and returns say 15 mintues later, the unit is 11 degrees, we change expiration to 4 hours from dispense and quaranteen the unit for only that patient.  Floor can re-request the unit as long and the transfusion can be completed within the 4 hour time frame from original dispense.  The unit never goes back to the general inventory.  They have 4 hours to complete the transfusion. 

You are going to hate me mollyredone (if you don't already), but why all females of child-bearing AGE?  Surely, this should be (albeit a horrible phrase) child-bearing POTENTIAL?  A female of, for example, 5-years-old is NOT of child-bearing age, but she is most certainly of child-bearing potential, and, if she is D Negative, or expresses a variant D other than Weak D Types 1, 2 or 3, has the potential to produce an immune anti-D, given the correct stimulus.  Should she not be tested?..........or are you only talking about peri-partum cases - in which case I apologise and withdraw my comments (totally).
 

Oops misread - sorry about that!

Whoa Auntie-D.  Abdulhammed Al-Attas was talking about anti-IgA, not anti-A.
 
Although our blood is SAGM and leukodepleted, and so you are correct in saying that we do not have to worry about high titre anti-A in our red cell components, we do, nevertheless, still have to worry (big time) about IgA in the remaining plasma.  If the patient is IgA deficient, and has high titre anti-IgA, there is sufficient IgA in the remaining plasma to cause a very severe transfusion reaction, and so Abdulhammed Al-Attas is completely correct about that.

If the DAT is negative, I would think that a post screen would be unecessary, as there was no transfusion reaction to begin with, hence nothing to stimulate any particular antibody.  (Theoretically I suppose, any transfusion may result in an "increase in titer", but no one does a screen after every uneventful transfusion.)
 
Scott

By elimiating the post antibody screen, aren't you removing the chance of detecting an increase in titre of an unidentified antibody that was too low to identify, but the titre now has risen post blood? Anti-E particularly could be missed.