NicolaHT

Alongside what gagpinks has said up above, I am primarily looking to use Approx 10% of our annual sample volume for ABO/D and screen (covering all ABO and D groups, positive and negative antibody screen) Infant groups performed on baby and cord samples which we routinely receive Rh/K for as many phenotypes as I can muster (I appreciate I'm highly unlikely to come acorss a r"r" ) Antibody panels (IAT and enzyme) for all clinically significant antibodies as defined in the BSH guidelines, and combinations of antibodies Reagent validation for full on-board management The one thing we are very undecided about, is on-board the panel cells have a validity on 7 days (this can be cumulative over a period of the reagent validity), so what is the best method for extending the reagent validity as long as possible, when and how to QC. On put on board when required and QC each time cells are loaded QC once a day regardless of how many time cells go on and off QC once a week and keep on board at all times QC once a week regardless of how many time cells go on and off I can draw many advantages and disadvantages for each, but also need to consider cost implications for reagents and QC, in conjunction with good practices and appropriate testing intervals. Any ideas / suggestions / thoughts are appreciated!

I just answered this question. My Score PASS  

I know this is an old post, but I wonder how you got on with your validation? I have just had a IH500 installed and am thinking ahead for validation plans / routine use, if anyone was willing to share information? Thank you, Nic

Congratulations! Very well deserved. A fountain of knowledge for all weird and wonderful serology!

Sorry Malcolm, I was referring to women who are D pos R1R1, given rr in an emergency and then develop anti-c! We wouldn't have time to Rh/K type or match these patients before the provision of emergency units, which are selected to be O Negative, K negative to protect against anti-D and anti-K, but we're a bit limited in protecting against anti-c.

Hi Pluto, In my hospital historically we always provided O neg, K-, rr units in adult emergency situations (as flying squad, Massive Haemorrhage Protocol activations on unknown patients etc...), but recently changed this practice to only provide O neg, K-. More often than not the units are rr anyway by the nature of rr being the most common phenotype in D neg UK donors. We searched for literature for and against prior to the change and didn't come up with much. It would be lovely to provide suitably Rh/K matched units for women <50 to protect against immunisation against anti-c in particular, due to the implications in HDN, but this is often not practically possible in the above mentioned emergency situations. And once a patient has received the emergency O neg blood, a Rh/K phenotype is void due to recent transfusion. We have also discussed around Rh/K typing all females <50 and thereby providing Rh/K matched blood (again to prevent anti-c development where applicable), but there are many situations where we would possibly end up with deviations against procedures to provide suitable blood which wouldn't be Rh/K matched, and covering a wide demographic of patients across two large hospital campuses logistically it would start to get very complicated to have these rules in place with suitably testing of >100 samples a day, recording in LIMS with appropriate special requirements updated and suitable phenotypes stored separately in the stock fridge for all different patients and situations. Maybe a bit too much of a headache to prevent the "what ifs" in every situation?

Thank you Malcolm. I read your reply on my night shift and then totally forgot to reply. I could find any literature relating to anti-Fy3 in those with the FYB gene, but I suppose half the reason we love this job is because not everything can be explained! Still, makes for a good case study!

Couldn't find the relevant forum in the UK bit, but any information would be grateful. I wonder if anyone can help me with something. I have a patient who has developed anti-Fya and anti-Fy3. She was phenotyped as Fy(a-b-), but genotype performed at IBGRL stated Fya negative, Fyb positive, GATA mutation positive (homozygous). I understand that due to the GATA mutation she would not express Fyb on her red cells, and so the phenotype would be correct, but would express it on other tissues so would not develop anti-Fyb. However, I thought that because she expressed Fyb on tissues that she couldn't develop anti-Fy3, because the Fy3 portion was part of the Fy structure. Have I misunderstood this? Thanks!

Sorry to jump on an old post! Malcom, is the paper for this information as below? Garner SF, Devenish A. Do monocyte ADCC assays accurately predict the severity of hemolytic disease of the newborn caused by antibodies to high-frequency antigens? Immunohematology 1996;12:20–6. I cannot find this paper anywhere, do you have any suggestions where I can access it? Thank you :)

Hi, Yes I did mean panels, the interpretation would be manual, As aposed to screening. Gagpinks, great thank you, those are the kind of things I’m thinking about. I suppose I’m wondering if we’re only keeping reagents on board for 48 hours, as with the ABO and Screening cells, we would then increase the number of panels we require per delivery and as such increase the costs. Or only put the reagents on at the time of need but as a busy laboratory this seems a bit impractical as you’d have to QC every time.

Hi all, We are considering using our IH-1000 analysers to perform all antibody identifications, which we currently do manually. Has anyone undertaken this in their laboratory? What kind of validation processes did you cover? I have a million and one questions so just trying to get a feel for it at the moment! Any thought would be useful Thank you Nic