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    Biomedical Scientist (Haematology/Blood Transfusion)

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Jermin's Achievements

  1. Hi All, We are about to move from using Bio-Rad IH-1000 to Immunocor NEO in our blood bank department. As most of you are already aware, the IH-1000 uses column agglutination technology (CAT), whereas the NEO uses Solid Phase Red Cell Adherence (SPRCA) assay. SPRCA is known to be more sensitive, which is great when picking up on elusive antibodies belonging to Kidd blood group system (I think ). My concern is about the techniques which employ the use of indicator cells that are coated with anti-IgG. It will only pick up on IgG antibodies and none of the IgM antibodies. How significant is this? Is there any way of picking up IgM antibodies using such technique? Or should we not worry since IgM antibody does not usually reaction at 37C? Regards, Jermin
  2. We had both in our laboratory. Must say, although the user interface for Stago looks like was done by a 7-year-old, it's a stellar machine. Reagents last lot longer, and QC passes almost every time without issue. The Stago's calibration is also a dream for most reagents: just scan a barcode and you're all set. I can give more details if need being, so please feel free to ask.
  3. Thanks for your replies and I believe I understand. So for this particular patient, we did send the sample to the reference laboratory which found the patient had autoantibodies, as well as alloantibodies (anti-Fya ). No. I will see if I can talk to my senior, but before that, I would like my colleagues to be able to understand why positive DAT or having autoantibodies may not be the end of the world, and that they could try and crossmatch the units in-house.
  4. Hi All, I have a question, but firstly good old story time for some context. I came across a patient who had positive antibody screen on all three screening cells used (BioRad). I was concerned this may be an auto and pan-reactive, and required units. Performed a monospecific DAT, showing a positive reaction to IgG only. By this time antibody panel finished cooking and showed the patient may have anti-Fya , but couldn't do phenotype. By this time I was nearing my shift so handed it over to my colleague and asked for some units to be crossmatched. However, he refused as DAT was positive and said he rather send the sample to reference laboratory for them to crossmatch. The next day I crossmatched units to verify if it could have been done in our laboratory (just because I am sad that way), and turn out the unit I crossmatched was compatible (which I wasn't surprised about) Question Why does positive DAT (or the cause of positive DAT) sometimes interfere with IAT techniques (such as antibody panel and crossmatch) and sometimes it does not? If both use AHG, then wouldn't positive DAT with IgG cause antibody panels shows pan-reactive with red cells? But obviously it doesn't, but I'm trying to figure out why, and I'm sure the answer is quite obvious. My laboratory seems very hesitant whenever they see anything regarding autoantibodies or positive DAT, and thinks that sample cannot be crossmatched in-house and needs to be sent off without even trying to investigate. Hopefully, by me asking this question, I can explain it back to my colleagues (but obviously take all the credit). Cheers in advance, Jermin
  5. Hi Malcolm, I agree with what you have to say. I have no problem relying on FDNA result, as accuracy is pretty damn high. The people who we are trying to convince/explain are the Midwives who don't understand why we are double checking something if you are meant to rely on it the initial result- and we kinda understand what they have to say. I will read the latest papers as you mentioned. I'm sure it would be helpful, Thanks, Jermin
  6. I don't even know how to begin to question that. Thanks for your replies as it has really helped. Since we are on the topic of FDNA, our laboratory is still getting our head around the accuracy of the test. If the FDNA can give a false negative result, and the accuracy as stated on reports show there is a chance of discrepancy, should we take that risk? Shouldn't we either fully be behind FDNA result, or we are not. If FDNA initially showed D negative, but the baby turns out to be D positive, then wouldn't there have been a chance patient would have had a sensitising incident long before we figured out the true D status?
  7. Hi All, Its been a while since I came back to this forum, but glad I feel like I have gained a lot more insight. I feel like I'm a bottomless cup. So I come with a question, for which there is not going to be a definitive answer (but with BB, is there ever one?), but hopefully, I would gain a bit of understanding. Background: So, our laboratory has started sending samples to reference laboratory for genotyping of the foetus by FDNA, which is great, since we would figure out the Rh(D) status of the baby (on most occasions) before they are born! So our laboratory has set up a flow chart which basically mentions that you do not need to send cord sample of Rh(D) negative mother if the baby is shown to be Rh(D) positive (or D positive, I am quite wary when trying to talk about Rh group), and only send cord if baby of Rh(D) negative mother if the FDNA shows the baby is Rh(D) negative, just to confirm the accuracy of FDNA. It sounds kinda counterintuitive, but we will soon be just not processing any cord sample for the ones we performed FDNA on. That means no cord Blood Group or DAT on a lot of post-delivery patients. Question: By missing out DAT, we would possibly be missing out on detecting ABO incompatible HDN. How significant do you think it is in the early stages? Is it OK to wait to see if the patient shows signs of jaundice and for them to send a DCT sample afterwards? Bonus Question: What does your Hospital/Laboratory do in the event of positive DAT on cord sample, and why do you do it? I had a read through one of the articles stating about the significant of DAT, but they called the Rh blood group as Rhesus, so I'm not going to take them too seriously Cheers, Jermin
  8. Cheers. I have the Introduction to Transfusion Science Practice. Robina Qureshi, and I will seek others when I get the chance.
  9. Hi Malcolm I have been using Rodak’s Haematology. Professionally speaking I am a Band 5 Biomedical Scientist still in course of doing his Specialist (which I may never finish) *sorry for late reply* Regards, Jermin
  10. Wish I knew, the book did not clarify. I guess its about time I started looking for another source of material.
  11. Hi All, I was wondering if antibody titre is performed on a pregnant mother who previously had HDFN. According to the books, it mentions 'After the first affected pregnancy, the antibody titer is no longer useful'. Therefore does it mean that it doesn't matter what the antibody titre level is, and should be referred to fetal medicine specialist regardless? Or if there is more to this, I would be grateful for some enlightenment
  12. Sounds like a very good idea indeed. Point taken. I should have also clarified that I was actually going to use the BioRad diluent (we just so used to calling everything PBS). Also I was not going to dilute it too much, so the concentration would be similar to a pRBC (how would I achieve such consistency? God knows). In the end it was just all a rough draft, which I can can assure you I will not be carrying out, and I am glad you have given me such pointers. I will contact the BioRad and see what they suggest. If they can't help much, I will use the donor units with known Rh phenotype.
  13. Thanks for the replies. Thanks for the insight Malcolm, I always assumed that there was a lot of K- units on the donor units that did not have K antigen status indicated. I will use the donor units in that case, and see where I get. The DiaMed reagents are, but not the NBS reagents. Thanks for that question, as it slipped my mind. Yeah, I think 10 might be too small as well, but as I don't want to use excess cards, and I want to perform the test manually and two analysers, I can't see myself getting more than 10, but I will go back to the list of possible genotypes and review the number. In the end, there is no point in being frugal if it means that the whole validation process was not undertaken properly. I had it in my mind that validation is what the laboratory conducts, and verification is done by the manufacturer. Yeah, all Rh phenotypes are clearly indicated, but as for K antigen status, it is not always clear on the donor units. I will see if I can get that information from the the National Blood Service I wish I knew how I could do that. I will need to probably check with the manufacturer's reagent sheet and see what sort of limitations and discrepancies there might be, otherwise it might be beyond me. I was planning on getting the reagent cells, centrifuge them to separate from the preservative it is in, then resuspend it in PBS. But I might go ahead with using donor units, so this might not be an issue anymore
  14. Hi All, I am about to venture into performing my first ever validation of a test. I have been tasked to validate Rh+K phenotype testing on the BioRad IH-1000 (two of them). We have been, until now, performing the test manually, but as work is getting busier, performing it on the analyser might prove easier (or at least motivate people to perform phenotype). I have been given advise by my senior on how to go about it: Select 10 Donor Red Cell units which have Rh+K phenotype performed Perform the phenotype manually Perform the phenotype on the analyser compare the result pat myself on the back, provided I don't mess it up The issue I have is donor red cells doesn't indicate if they are K+, and I wanted some K+ as well as K-. I could always keep testing a lot of donor units until I come across a K+ unit, but I don't want to was a lot of cards (but that might be my last option). If I choose the NBS or BioRad Antibody Panel Cells, then the issue is the strength of the test cells, as they are, I think, 0.8%, and it does not fully represent the way we perform our phenotype manually, as it uses around 5%. I can always try and make the strength of the solution stronger, that is another option. So this is where I am at. If anyone has a suggestion, or better a complete plan, then I am happy to hear it. Also if there is any point I missed or need clarification, please feel free to ask, I'm fixed to this specific thread all night long. Cheers, Jermin
  15. I just answered this question. My Score PASS
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