emergency room

The issue here is the alloadsorbed plasma (2X) reactivity is still positive and same reactivity strength compared to the neat plasma ? low affinity of anti-Jra ? but why the last couple times we were able to adsorbed out the anti-Jra. Can the patient make another highs to antigens sensitive to enzyme (the adsorbed cells are phenotypically similar cells papain treated)? I am going to try perform the eluate and test it against Jra- cells.

I wanted to perform an elute on the adsorbed cells to see if the anti-Jra gets adsorbed out or there maybe additional alloantibodies. We have worked a couple of anti-Jra cases and most can be adsorbed out in order to rule out any other antibodies to common antigens in the adsorbed plasma. Emergency room

Hi, We recently encountered a pregnant mother with known history of anti-Jra. We have worked on her samples on two separate occasions and was able to rule out the presence of other common alloantibodies using the alloadsorbed plasma. Just three week ago, we worked on the her sample and this time the alloadsorption failed to remove anti-Jra. The reaction strengths of the adsorbed plasma were no difference compared to neat plasma when tested with the panel cells. DAT is negative. Patient's neat plasma was non reactive with all Jra- cells. ? additional antibodies to enzyme sensitive antigens? I am thinking the next time, I probably should perform elution to see if the anti-Jra get adsorded. Low affinity anti-Jra?? Any thoughts? Emergency room

Hi, Anyone encountering problems with Immucor 3 cells screen, Lot 32253 cell 1 (donor ID: B5478)? Emergency room

Hey everyone... thanks all for your input. Do you all re check the dilution when change to a new lot of the Ortho confidence QC antibody? or the particular dilution always work between lot to lot? Emergency room

I am revising the daily reagents QC SOP and was wondering if anyone dilute their Ortho confidence antibody when QCing their tube antibody screen cells and gel screening cells. If so, at what dilution? and if this is prepared daily when running QC or prepare in batches. Emergency room

What about reactivity that looks possibility of an alloantibody in the ECHO screen and yet ECHO ID panel non conclusive? Recently, we have a problem where the reaction in screening cells "looked" like a anti-Jka, two out of 4 homozygous Jka cells (ECHO panel) was positive and yet peg tube panel was negative and ficin negative..... How far should one go trying to prove its a significant alloantibody? Should I be worried since ECHO is known to pick up Kidd antibodies.The patient was typed and found to be Jka negative and we decided to give Jka negative as precaution. Does any of your flowchart address issue of where ECHO screen matches an antibody but ECHO ID panel is unclear? Emergency room

Thanks! Malcolm...as always awesome!

Hi eveyone, I have seen a few postings about competency assessment in the transfusion service section. I am wondering if anyone can share their process of competency assessment in a Reference lab? Currently, we do have a plan/process and have been doing it for almost two years. I planning to revamp the whole process and hopefully to come up with a better and lean way to do it. Ermergency room

Hi, Emwilson can you tell me where did u get your DTT powder from? In fact I treated 2 sets of screen cells, subjected to the same DTT treatment process. Is that possible that one set worked and the other did not? You probably right about using patient's sample. Malcolm, I cannot use zzap because i cannot even get my DTT work. Isn't zzap consists of DTT? Emergency room

Oops, Sorry Malcolm, I should have explained more in details. Few months ago, I prepared 0.2 M DTT using DTT powder and dissolved them in buffered saline of pH 7.3-7.4. I read this from the Red Cross Immunohematolgy methods and procedure book. After preparations, I treated three cell screen with the 0.2M DTT and ran the cells against anti-k antisera. It clearly showed that the k antigens have been denatured as the reactions were negative with anti-k. However, when I tested the treated cells with a known patient with anti-k, the reactions were positive ( the reaction did decreased from 3 to 1+-weak positive). So last week, I thought well maybe the pH of the buffered saline wasn't right, so I experimented by modifying the pH of the saline with phosphate buffer. Unfortunately, it still didn't work at all, worst were no reductions of reactivity and anti-k control came out positive. Any thoughts? Emergency room

Hi everyone, Need some help here. I have been pulling my hairs on this for days, wondering where could have gone wrong in my preparations. Need some advice/help here to gurus who prepare 0.2 M DTT for testing. Peharps some tips on how to get it right (maybe have "tweaked" a little during make up of the solutions?). Any help is appreciated!!! Emergency room

Sorry everyone for the late reply. I went back and reviewed the workup again and yes the DAT was repeated in tube and it was still positive (1+s). The initially DAT performed was done on gel. Because we were concerned about the so-called "blocking" effect, we also EGA treat the cells and used the treated cells to performed weak D testing. Emergency room

I have been scratching my head:confused: trying to come out with an explanation of this strange serological finding of a neonate sample. This baby girl was born two days ago and mum has anti-G. ABO/Rh and DAT were requested to be performed on the baby's sample. Baby girl's blood type was group O which is compatible with mum ( mum is group O negative). The D typing of the baby was negative at IS and the weak D test was negative. The DAT performed later was found to be 3+ with anti-IgG. Baby's Rh phenotype: C+,c+,e+,E-. My question is why weak D testing was negative where cells have positive DAT? Wondering if anyone has encountered such testing scenarios or perharps a good explanation to this finding. Thanks Emergency room