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Lingkwyz

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Everything posted by Lingkwyz

  1. Could it be because of warm autoantibodies "saturating" the D epitopes? We see a lot of WAIHA cases from where I work and the suppression of antigens , especially D, which D-like specificites are far too common. After subjecting these patients with immunosuppressants, their antigen test remarkably improve as well.
  2. Well, after three pages, I only have eric1980 on our side.. I don't know, but as per my short experience, It kinda suffices the need. Although, if ever you are unlucky, if you happen to come across an antibody to a more frequent antigen, let's say cellano, then problem it is. PS. - We too keep panels 3 months expired. For exclusion purposes.
  3. Believe me. It's hard to talk to rocks guys. I've tried. Please give me references.
  4. Omaygad! They're implementing it here! Ab ID with DAT (solid) is autocontrol for them! We're dead!
  5. That was what I had in mind! But of course, I had to confirm it from you. Thanks anna.! Another question for all.. For Antibody Identification, is an Anti -IgG-only DAT enough to replace autocontrol to differentiate the antibody as allo or auto? Thanks!
  6. Thanks for the details Malcolm. There's a reason why I don't call the shots and I'm keeping it that way. I'm endorsing details to our director. Whatever he decides on, its all in his hands. Anyway, I got the chance to solve the 6-year old ABO discrepancy. That was already enough for me. (Although they didn't accept it!)
  7. So basically, because you can control/standardize the activities within the technique, it makes the technique more sensitive. Let me rephrase. What I'm getting at your input, and please correct me if I'm wrong, is that: minimizing human intervention "intra-procedure" leads to reduced "human error". That makes it more sensitive than tube method? Sorry Anna if I'm really stubborn at this but I've got another question: The purpose of washing cells in tube method is to eliminate free unbound IgGs which could "neutralize" the AHG, why isn't washing necessary of AHG Cards? (Poly and mono). Thanks so much Anna.
  8. Hi Anna! Gel Card: In my experience, which hasn't been that long by the way, enzyme techniques are "supplementary" methods to give addtitional conviction to the antibody in question. (Please pardon me, I'm using my own words.) Never has it been done that one used enzyme techniques "catch" solely and got away with it. It would be too naive for a person to do so. I was waiting for somebody to say "because Gel Card Technology is more sensitive than Tube Method". It could only be the missing piece. Everyone is telling me so, but no one can answer my follow-up. Anna, please enlighten me why Gel Card Method is more sensitive that Tube. (Ergo, Non-IAT enzyme tests are done on this method.) Anti-PP1Pk: On her first visit, way back 2011, she was 18 months old back then. The lab (I wasn't here back then!) had to call in her mum, her siblings, and some of her folks. Having incompatible for all of the prospect donors, the hospital had to cancel her Cardiac OR. Now, she's 6 years old, still battling for the cardiac problem and still no donor. (And yes, "inbreeding" is popular to these peeps.) Hi Malcolm! Can you probably hook us up with the unit if our director chooses to seek help from IBGRL?
  9. Tried to resolve the reverse grouping discrepancy.. Adsorbed patient's plasma with known P1+ reagent red cell using Method 3-12 of the AABB Technical Manual 17th edition. Results: A1 Cell: 0 B Cell: 3+ P1+ cell: 0 -The results were not officially reported for we don't have a "local" procedure on Adsorption Techniques. Nevertheless, I had to cure my itch and well, it really paid off. The patient's blood group was resolved in my own self but officially, the patient is still "Blood Group Indetermindate" ^^
  10. I will try to collate all your inputs in one word: "PRAGMATISM". I would rather say that as I learn from you guys, I always bump back into this word. Well.. wait! Hold your horses.. I might get a double-dosed sermon with this, but let me try to explain further: Although there are SOPs, AABB Methods, Guidelines, PPs, (Policies and Procedures), I could only imagine how you do your stuff in the field we all love. Its that: "Hold my beer, I got this!" moment that really starts it all, then comes the protocol for Kidd, or the necessity of enhancement techniques or the pesky procedures for adsorptions. If I may quote Malcolm's reply on one of my started threads: The "worth" this great person might be pertaining to is that: Wait-a-minute.. I-know-this-antibody-moment, or the "Oh I see you Mister antibody.." moment plus the eureka dance.. Though its the science is what brings us together, I just love the way you how share your approach and "hunches" to our field. I might be too premature to this field myself. I need to develop that 3rd eye. That stare to the antigram that looks beyond to the pluses and minuses. Nevertheless, I learned a lot from all of you guys.
  11. Hi anna! Great to hear from you! You seem to be into the gel technique. The way you explained was so clear! So anna, if adding enzyme to the mix would be sufficient as "helper" for the agglutination, why do we still add Anti-IgG to the tube method testing of enzyme-treated cells? As I experience, the tube method was and still is now doing the same? Only in gel that we get the chance to "omit" the AHG and do the test "Non-IAT". So, I started to presume that there must be something in the "gel" or the technique that grants us to do so. Thanks Anna.
  12. Weak ABO: Oh. Then it could be a multitude of other possibilities. So, as routine lab, it might happen that a newborn be "temporarily mis-typed" in cases of weak or subgroups of ABO. As they come of age, they could probably be corrected. Am I getting it right ? Anti-PP1Pk: Interesting as it may seem, the sample had been sent to a reference lab. Confirmed as Anti-PP1Pk. Open and shut case as it may seem. But the curious cat was at it again: 6 year old female DX: Congestive heart disease. Blood group: Indeterminate Solid phase testing: Anti-A : 4+ Anti-B : 0 Anti-D: 4+ Rh Ctrl: 0 A1 Cells: 4+ B Cells : 4+ Ab ID: Confirmed Anti-PP1Pk from reference lab -"Indeterminate" for 6 years. 1st testing 2011 (18 months of age) ^^
  13. What I'm getting at your suggestions is that; if the patient has this "Non-specific Reactions", I must assure myself that neither of the Kidd antigens are negative, which means, all "Nonspecific Reactions" must be antigen typed for Kidd. Am I getting it right guys?
  14. Hi Malcolm.. Seems a dilemma. Was really wrong at testing the cord sample with the anti-A1 lectin. Did me no good. Curious as I was, needed to challenge the clause in the reagent insert that said: "Newborn testing results will not be as expected" Thanks for injecting the idea of the existence of "precocious babies". The baby was group AB by the way with 1+ in Anti-A and 4+ in Anti-B on newborn gel card testing. Was being told, again, that these are usual results for AB newborns. (Weaker A antigen expression against B antigen on AB newborns) Any inputs? PS- by the way, I got a patient today with a suspected Anti-PP1Pk.
  15. The enhancement possible for us was LISS. That's it. So you mean PEG would be the best to use dealing with Kidd antibodies?
  16. Another question: Can you detect, on a routine bloodbank, group A2 on a cord blood or newborn sample? Reactions: Sample: Cord Blood 1+ reaction with Anti-A (routine) 0 reaction with Anti-A1 Lectin (Dolichus biflorus) Thanks
  17. I see this as a current dilemma in our lab since our "seniors" are too fond of the "Nonspecific Reaction" dump. And, if you have read my previous post tilted: "Missing Plasma Protocol", we have faced a patient who had a transfusion reaction which apparently had Anti-Jka but was misdiagnosed as a Nonspecific reaction. I would want to ask for ideas so I could ,at least, evade this problem. Thanks Smiller.
  18. I saw the "syalic" acid typo, but ain't got no grammar nazi in my blood.. ^^ Living in the lower end of the food chain in our lab, as I am right now, I can't call the shots. And suggesting far off procedures are quite taboo in these kind of people. (As you may now realize, I'm not a Saudi.) I would loveto see one day that these practices of yours becomes a procedure here, or eventually I get to work with an institution which is following one. Thanks. Yes sir. My question was: what made these neutral cards so special that it is acceptable to omit the AHG?
  19. I would want to try using the enzyme-treated cells to AHG-incorporated gel cards but it would be non-procedural in our case and would be out of the manufacturer's instructions. Ergo, mistakes would be under my head. What got me to this question is that on tube method, we do IAT with enzyme-treated cells but on gel card we don't. Why? And, I dont know if any solid phase technology brands uses enzyme-treated cells. (Because Immucor says they don't.) ^^ Thanks Malcolm Needs.
  20. What we have here sir is one, Gel Card Technology, two, Solid Phase technology (Neo and Echo) and tube techniques. I'm just puzzled why Neutral Gel Cards don't have Anti-IgG in the mix. 'Coz by then, Enzyme treated cells done on neutral cards are "Non-IAT" procedures. Please correct me if I'm wrong.
  21. Using enzyme-treated cells to do screening is not mandated in our institution as well, but having the reagents expire without use makes me cringe. I may be one of the few doing this procedure and I find it really helpful. My trouble is, as I noticed, doing enzyme-treated cells on tube involves the addition of the antihuman globulin while the gel card method only involves the neutral buffered gel. Is there any special characteristic of the neutral buffered gel to eliminate the AHG off the mix? Thanks
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