BBNC17

Are there any other technologies out there for performing platelet crossmatching besides Capture-P? Also, if anyone is using or has used Capture-P, what are your thoughts are the technology and process? We are considering this as a request from a physician and we already have the Immucor solid phase equipment in-house. Thanks!

I was wondering the same about the platelets in WB. There article addresses it briefly stating "In Pittsburgh, the decision was made to keep WB for up to 14 days in the refrigerator as it was clear from the literature that cold-stored PLT function was well maintained for at least that length of time. Continuous agitation of WB is not recommended as it does not enhance PLT quality and contributes to increased hemolysis during storage. On Day 15 the unused units of WB are returned to the CTS laboratory where the WB is concentrated into an RBC unit by removing the PLT-rich plasma, and the resulting RBC unit can be stored for an additional 6 days." Not sure what is meant by "the literature", but there are a few cited articles that seem like they may shed some light on this, but I have yet to look at them.. Reddoch KM, Pidcoke HF, Montgomery RK, et al. Hemostatic function of apheresis platelets stored at 48C and 228C. Shock 2014;41 Suppl 1:54-61. Nair PM, Pidcoke HF, Cap AP, et al. Effect of cold storage on shear-induced platelet aggregation and clot strength. J Trauma Acute Care Surg 2014;77:S88-93. Becker GA, Tuccelli M, Kunicki T, et al. Studies of platelet concentrates stored at 22 C and 4 C. Transfusion 1973;13:61-8. Yazer MH, Glackin EM, Triulzi DJ, et al. The effect of stationary versus rocked storage of whole blood on red blood cell damage and platelet function. Transfusion 2016;56:596- 604.

From the transfusion article "WB offers several benefits over component therapy including providing simultaneous treatment for both oxygen debt and the coagulopathy of trauma; it is a more concentrated product compared to reconstituting WB using component therapy; and cold-stored WB contains PLTs that appear to have equivalent or better hemostatic effect in both in vitro tests and in clinical trials, compared to PLTs that have been stored under conventional room temperature conditions. Another benefit of WB that is perhaps harder to quantify is the simplification of the resuscitation effort with its use, especially in the prehospital environment. In such settings, where the clinical staff are task saturated, patient intravenous access is limited, and storage space in helicopters and ambulances is very limited, having the ability to provide a balanced resuscitation fluid in one bag instead of up to four bags is valuable. This is important because any delay in the provision of blood products in hemorrhagic shock can be lethal; mortality is increased by 5% for each minute there is a delay in the delivery of blood products."

Thanks for the info! Any idea how they are testing the titrations? I've heard I.S. from some sources and others are taking it through an IAT in gel.

We (blood collection center) are looking into providing Group O Whole Blood, with low anti-A and anti-B titers for treatment of trauma patients. Is anyone else doing this? If so, what is your testing protocol on how to identify a donation as "low titer"? What are your titer cutoffs for anti-A and anti-B? Thanks for any assistance!

We had an Rh positive donor tested at another facility as D+ C- E- c- e- . Typings were confirmed at our facility. Don't have any demographics on the donor yet, but how common (or uncommon) is this?

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We currently have a ficin-treated panel from Immucor and the papain-treated panel from Quotient. We have a tech that claims they used PEG with enzyme-treated panel cells at their previous job. Is this necessary? Their rationale was, since the panel has 10 untreated cells and then 10 enzyme-treated of those same cells, so they would run both the untreated and treated in PEG and perform a rule-out based on comparing the reactions. The package insert from Immucor says to not use potentiating reagents and the Quotient package insert says you may use potentiating reagents. I've always thought of enzyme treatment as a potentiating reagent for certain antigen groups, so why would you need to need to add PEG and risk diluting out a possible antibody? Thanks for any assistance!

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Our collection facility is going to start sending out patient samples and donor units for RBC genotyping on the Immucor Bioarray HEA system and I'm curious as to what this could mean. Will they be able to label units based on the HEA results since it's FDA licensed? will they still need to confirm serologically? Will they need to run more than one donation from the donor to confirm the genotype ("predicted phenotype") before labeling it or confirming serologically? How would this differ if they were using a non-licensed platform like the Grifols ID Core from Progenika? Thanks for any guidance!

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Just out of curiosity.. in your experience, how successful have you been able to remove the CD47 interference? I've read numerous adsorptions using enzyme treated cells have shown to do the trick. Also, the Immucor anti-IgG clone that doesn't detect IgG4, but we haven't seen these type patients yet and are anticipating seeing them soon.

Hello all, We are looking for larger tubes than our normal 12x75 tubes to use when performing adsorptions. I'm finding that a lot of serum glass vacutainer tubes, that would be the perfect size (16x100), are silica-coated. Would this silica coating interfere with any of our adsorptions or post-adsorption testing? Thanks!

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Curious as to the benefits vs. the time it takes to prepare, validate and store these enzyme stock solutions (alpha-chy, pronase and trypsin)? Currently at a reference lab that would likely send antibody to high-incidence antigen workups out as we don't have much access to rare antisera and cells at the moment. However, before we send it out (or while it's being worked up), we would like to at least try a narrow down the classification of the antibody and also perform enzyme and/or DTT treatment on pheno-similar cells, or adsorb out the antibody, to investigate any underlying allo to common antigens. This way we can at least provide the hospital with a preliminary report of the patient phenotype and a potential aby to high-incidence antigen and any ID'd underlying aby. Eventually, when we build up our rare antisera inventory, we'd like to perform these IDs in-house. For now, do you think DTT and papain are sufficient enough since we are sending these workups out anyways? Looking at a few enzyme/chemical reactions on high-prevalence antigen charts and, other than -Yta, trypsin doesn't seem to determine any of these abys.

Thanks for your replies! Yeah I'm seeing that especially with trypsin. Using Judd's Methods (and the BAEE units of activity per mg calculation) and trying to choose a trypsin on Sigma's website has already proven to be quite a headache

Looking for sources of alpha-chymotrypsin, Trypsin and Pronase to help with our ID's of antibodies to high-prevalence antigens. Any suggestions or personal experiences on where to source these enzymes from? We have freeze-dried papain and DTT already in-house. Thanks!

Validating a new COBE for a 1-liter RBC wash and a 2-liter RBC wash. When it comes to the PQ, we are setting our expected results and are struggling on how to prove the wash worked as expected. Things like how much volume was lost and the amount of red cells we are able to recover are our main two parameters currently. Should we look into protein levels of the blood before and after the wash to ensure the RBC was adequately washed? Any help and guidance will be much appreciated!

Thanks everyone!

Posted this on the Transfusion Service board and then realized there was an IRL board! As you can tell, I'm new to the board here and excited to interact with you all regarding transfusion news and content! I'm helping bring an IRL online and have a rough draft of IRL workup flow charts that I'm collaborating with other blood bankers in generating. I was wondering if anyone had some to share or knows where to find other charts to cross reference ours too. Specifically flow charts regarding WAIHA workups, cold agglutintin workups and DARA workups. Thanks for any help!

We have a Helmer EBA centrifuge in our lab for routine blood bank testing. We have a 12-tube rotor with these tube holder inserts to hold our 12 x 75 tubes. The inserts are plastic and several have broken due to normal wear and tear. We recently ordered some new inserts and before we start just replacing the old with the new, I'm wondering if there needs to be some sort of validation performed? Seems pretty petty, but I've seen other situations where a validation isn't obvious, but was required. Thanks for any assistance!

Hello all! New to the board here and excited to interact with you all regarding transfusion news and content! I'm helping bring an IRL online and have a rough draft of IRL workup flow charts that I'm collaborating with other blood bankers in generating. I was wondering if anyone had some to share or knows where to find other charts to cross reference ours too. Specifically flow charts regarding adsorptions and flow charts regarding cold agglutintin workups. Thanks for any help!