NicolePCanada

If we only do D typing on babies from D negative mothers and a weak D or Du test needs to be performed, the results of the weak D is only valid if the DAT is negative, so a DAT would need to be performed. Therefore, an ABO and DAT would be a good place to start. Just my thought.

We use Immucor for our reverse (back) type and the package insert indicates that we need to confirm the reactivity of the A1, A2, and B red blood cells, not the negative results. So, we only daily QC that they are reactive.

We use Immucor for our reverse (back) type and the package insert indicates that we need to confirm the reactivity of the A1, A2, and B red blood cells, not the negative results. So, we only daily QC that they are reactive.

https://www.nacblood.ca/resources/guidelines/CMV.html
These are the Canadian National Advisory Committee Guidelines for use of CMV Negative Blood Products.
 

https://www.nacblood.ca/resources/guidelines/CMV.html
These are the Canadian National Advisory Committee Guidelines for use of CMV Negative Blood Products.
 

https://www.nacblood.ca/resources/guidelines/CMV.html
These are the Canadian National Advisory Committee Guidelines for use of CMV Negative Blood Products.
 

When we still saw antibody screen orders prior to antenatal RhIG administration, the OB providers wanted the patients drawn within 7 days of their appointments. I always assumed that this was a recommendation of the American College of OB/Gyn. They stopped ordering those antibody screens several years ago, so I'm again assuming that there is no longer a recommendation for that testing. That particular practice very much follows guidelines.

You know me Scott, I hate to look for zebras when I hear the sound of horses hooves (!!!!!!!!!!!!!), but did you see the reference below, where a patient "came across" the same donor a second time (fortunately ex-vivo).
Lemay A-S, Tong TN, Branch DR, Huang M, Sumner C, Oldfield L, Hawes J, Cserti-Gazdewich CM, Lau W.  The first case of severe acute transfusion reaction caused by anti-Sc2.  Transfusion 2018; 58: 2506-2512.  Doi:10.1111/trf.14867.

Oh no, I get it.  We do not dismiss things like this here out of hand either!  But I know of other Labs where they have different policies regarding follow-up testing for cases like these. (I suppose they would say that when they hear the sound of horses hooves they don't bother looking for aardvarks, pigeons or spyrogyra...)
Scott

To address this question of safety, I would like to see hard data from the AABB community as to the frequency of events where an ABO discrepancy was detected in the second ABO determination that was not detected in the first ABO determination.  More importantly, did the detection of an ABO discrepancy (missed by the first ABO determination) prevent the transfusion of ABO incompatible red blood cells? 
My responses above assume that the ABO discrepancy was demonstrable by repeat testing of the first blood sample.

　This is the Canadian Standard:
A little vague.......
　
10.6.1.3
To provide ABO- group-compatible red blood cells, there shall be at least two determinations of the recipient’s blood group on record: one from a current sample and the second from the
recipient’s previous records; 　 testing of a separate sample collection; or retesting of the same sample where positive patient identification technology was used at the time of sample collection. Note: Positive patient identification technology refers to a computerized system that uses a barcode, radio- frequency identification (RFID), or another electronically readable element on a patient’s identification band to confirm identity.

I'm very glad you shared this wonderful news with us. We may have never met but you have helped countless people including me in my short time as a member of this forum. I am very excited for you and hope to one day be able to meet you in person. Congratulations! Please don't ever leave this forum, it wouldn't be the same without you.
Nikki

I'm very glad you shared this wonderful news with us. We may have never met but you have helped countless people including me in my short time as a member of this forum. I am very excited for you and hope to one day be able to meet you in person. Congratulations! Please don't ever leave this forum, it wouldn't be the same without you.
Nikki

Poly Specific AHG is less expensive.
 

I agree with NicolePCanada - I would have made a special effort to search you out and introduce myself Malcom  
Good conference overall.  More research based than conferences I'm used to going to (I've been to CSTM and AABB in the past), but really interesting.
However, I'm concerned that the rest of the world thinks Canadians eat cookies for breakfast, lunch, and dinner .  
sandra

And if you were going to be there Malcolm, I would have changed my plans around and driven 4 hrs to Toronto, just for the opportunity to shake your hand and the ability to say, "I met Malcolm Needs"

And if you were going to be there Malcolm, I would have changed my plans around and driven 4 hrs to Toronto, just for the opportunity to shake your hand and the ability to say, "I met Malcolm Needs"

Early in my career we had a tech working in chemistry who was, shall we say, a tad bit arrogant!  I figured he had measured 5 mls while making up reagents enough times he could do it without a graduated cylinder.  He just "eyeballed" it.  It was requested he seek employment else where as one set of CAP Proficiency testing was failed miserably and his reagent prep was determined to be the cause.  

Scandalous, Scott !!!!!

Or you can just eyeball it!
Scott
 

But David, what difference would knowing the specificity make?

It probably makes some doctor some where feel better.

Thank you Malcolm. I knew you would come through on this one. I am going to find that book straightaway.

Having met both Lawrie Petz and George Garratty, co-authors of their seminal work "Immune Hemolytic Anemias" (in this case, the 2nd edition, 2004, Churchill Livingstone), both of whom having signed my copy of their book, and having written a book review of this work for the British Blood Transfusion Society, I am prepared to put my head above the parapet, and dodge the shots!
The first thing I would say is "my own" (as it were), rather than from either of these two world renowned experts; it is this.  Does it matter one iota what is the specificity of the auto-antibody?  The antibody specificity will make no difference WHATSOEVER to the treatment of the patient, but makes even less sense concerning the patient if they actually require a transfusion.  If the antibody specificity turns out to be anti-H, are we going to transfuse Oh units of blood?  Not likely!  If the antibody specificity turns out to be anti-I, are we going to transfused adult i units of blood?  Not a hope!  If the antibody specificity turns out to be anti-HI, are we going to transfuse Oh, adult i blood?  Not in a million years, as nobody has yet been found who has the Oh, adult i phenotype, and so such donors do not exist.  There is a possibility that someone with atypical paroxysmal cold haemoglobinuria MAY require pp blood, but, boy oh boy, such a situation is disappearingly rare!
So, let's turn to the requirement to perform a titration.  Without a doubt, it is true that most individuals with clinically-significant cold auto-immune haemolytic anaemia (CHAD) have a high titre auto-antibody, but the word "most" does not mean "all".  Once again, I apologise for quoting one of my own publications, we published a case (Win N, Needs M, Rahman S, Gold P, Ward S.  An unusual case of an acute haemolytic transfusion reaction caused by auto-anti-I.  Immunohematology 2011; 27 (3): 101-103.) were the titre of the auto-antibody was quite low, but still caused undesirable clinical sequelae.
Let's turn then, to what is actually useful in the diagnosis and monitoring of CHAD, and, according to the two accepted experts on the subject, the ONLY worthwhile test is to see if the auto-antibody is reactive at STRICTLY 37oC (see the chapters on CHAD in the book by Petz and Garratty).  AHGGGGGGGGGG, that should have been STRICTLY 30oC and above!  Apologies to all.
I hope that helps!

I'm sure you sent them a card.......