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I thought the bottom barcode is probably product code, I was thinking maybe they didn't use ISBT compliant number due to copy write? But as you say no DIN would be a major issue both for compliance with ISBT standard and for checking procedures.

Thanks for reply How do you find the pHix? What Ph does it give? and do you ever have to adjust it? ?

Currently we are using 4 x 4 labels for our aliquots as per ISBT standard. These are too big for our neonate bag and attaching them is messy. I have seen some examples of 4 x 2 labels been used that would be perfect size however I'm concerned about compliance with ISBT standard. Can anyone tell me if such labels are acceptable under ISBT128. I have checked the standards and it always referances the 4 x 4 label and there is not mention of 4 x 2. Also all examples of these labels I have seen are missing unit number. This seems like the most important number to me, how can it be dropped from the label? How can the checking process be completed without unit number been shown? Thanks

Does anyone make there own buffered saline? we have just switched to using the Ortho Vision and our local Vendor recommended normal saline not buffered. I have previously used the Vision in the UK and we were always advised to use PBS Ph7.2 and always did, so I was surprised by this advice. Since starting to use the Vision we have noticed a significant number of Cord blood samples with strong Pos DAT and Ctrl well positive, and C3 when checked with the Mono DAT card. When I asked the vendor regarding this he told me this was normal and to be expected, however I told him I don't believe it is as in my 2 previous years of using it I had never had a single case of this. I requested they contact Ortho regarding the issue and they came back with checking saline Quality/Ph! The Ph of our normal saline is 4-7 not within specification, the issue I have is that the only PBS I can get hold of here is for molecular biology use and around $100 a liter, as we are using about 150L a month this is not feasible. The ingredients to make PBS are cheap and its easy, or alternately we can just make the buffer to add to the saline. My concern is about QC and if we will have any issues from CAP/ISO,AABB etc. Just wondered if anyone else is doing this and if they have had any issues? Alternately I see Immucor make a product call Phix, that can be added to saline as a buffer, although more expensive this would be far cheaper than the PBS. does anyone use this product and have any feedback? There is also a powdered PBS product from a company called RPI which is the right specification and cost effective however they state that its a research product only, has anyone ever use this? Thanks

We were provided the attached document by Ortho regarding saline specification. PH saline.pdf

I know this is a bit late but I have recently validated titer on the Vision and found it to have at most only a 1 titre dilution difference to Bio-Rad gel cards. Some higher some lower but most agreed. I was pleased with the outcome, just a little disappointing that the only result you get is "Done" and it doesn't give an interpretation hence manual interpretation and entry is required.

JAT is the automated survey. I think J is a manual only survey. I wasn't really discussing simply asking if there are know issue with CAP samples on Ortho Technology, as certain technologies do have know issues with EQA specimens. As this analyser isn't in use yet we are reporting the results from the IH anyway.

I carnt really see any other explanation for it and would be interested to hear from any other Ortho users who have this latest CAP. Yes the backgroup was clear on Diamed/Bio-rad and they too had a c Poitive A cell, I tried the same cells on Ortho and it was Poitive, then switched to a screened A cell that was c Neg and it was clear. I didnt panel the antibody but going off the screening cell result it can only be anti-c.

It could be that the cells are coated but not sufficient to get a positive result. However when you perform the eluate on a large enough number of RBC'c the amount of IgG removed from these red cell's is then enough to coat and cause a positive reaction on the screening cells. Also the cells from the DAT will be heterozygous cells, hence you will get a stronger reaction from screening cells that are homozygous if sufficient antibody is eluted to coat them.

JAT-C Got to the bottom of it with one of them, it was Anti-c antibody positive and was cold reactive with the A cells. Switched for some c- cells and now clear.

How common is DVI? Have done a google search but carnt find much information. Any sites that actually dual screen neonates or adults with both DVI+ and DVI- D clones? If so how often do you identify one if ever? Thanks

I'm currently in the process of validating a new analyser, the Ortho Vision. I have validated this particular analyser before in the UK back in 2015. Now I'm working for a lab that is currently going through the process of AABB accreditation so I want to make sure I have covered all their requirements as this is my first experience with AABB. So far I have done comparisons, reagent on-board stability, carry over for antibodies (tested up to the Ortho claimed limit of 1:1024 titre), I also intend to do repeatability, running the same samples 5 times in a row to make sure the grading and interpretation is correct, the pathologist wanted 20 but I pointed out there is no way we will get 20 runs out of a transfusion sample. This is as much as I did in the UK and we had ISO shortly after and they were very satisfied with what we had done. As I have no experience with AABB I would like to hear from anyone who has gone through this process and has AABB experience. Is there anything I'm missing? Thanks

I'm in the process of validating our new Ortho vision Analyzer and have just run our latest CAP specimens however I'm getting false positives on the back groups. Does anyone else use this analyser? are there any know issues with CAP specimens? Thanks

Currently our lab ignores +/-, 0.5, or weak positive results (depending what your technology classes them as) on titres, hence we only report the titre as the value that gives a minimum 1+ reaction. Is this usual practice? recently we are getting alot of +/- Anti-D's that are only giving very weak reactions in IAT but confirmed in the Enzyme, hence when titrated they dont meet the criteria to be classed as a even a "neat" so we report them as too weak to titre. Just wanted to check if this is standard practice as in my previous experience all titres were sent to reference lab and I never saw any report that wasn't at least a "neat" Thanks

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In the UK the MHRA who are the UK equivalent of the FDA licence all blood facilities and hospital blood banks. One area they are very big on is change control. I just wondered how much the AABB focus on this area as at the moment our laboratory does not have a specific documented process for change control. Thanks

Yes and this is what I've gone with, think its the easiest all round and the way I'm used to working. Thanks

Annual Management Review meeting. Although AABB just refer to it as scheduled management review in the standards, I've only ever know them to be done annually unless AABB expect more frequent?

I wish, if I was I could make it 100 times better than what we have, its been designed by people who have clearly no concept of blood bank.

If AABB accredited is there a minimum expectation from the AABB as to the Blood Bank topics discussed at the AMR? We have our AMR coming up shortly and are also starting our accreditation process with the AABB. I want to ensure we have covered all bases. Thanks

I am working on implementing a new blood bank system which has a very poor Crossmatch/Blood issue process, I'm looking for some examples to give to our IT department as to how other systems manage this process because I think they think I'm wanting something that is top level functionality when I see it as a basic requirement. Please can you give a brief outline of your LIS Crossmatch/Issue processes for me. Thanks

When you say you have them all listed, do you mean you have them listed as individual product codes, I'e the product description but under one main category heading? or you have a category for each class or product. For example a category for packed RBC's with all the possible product's within this description, then a separate category for apheresis RBC's with all the possible products listed under this category, a seperate category for irradiated RBC's with all the possible products listed under this, then a different category for apeheresis irradiated RBC's and so on so forth, rather than just calling them all PRBC's then listing the individual product descriptions under the one category for PRBC's. If you say the Dr's only see the 4 main category's this implies all PRBC's individual codes are listed together under the one main PRBC category? This is the way I'm used to it been. Thanks

I'm in the process of setting up a new LIS for our lab, the current settings in the system have 100's of component categories for example, Packed Red Cell's, Packed Red Cell's Leuko Depleted, Packed Red Cells Irradiated and so on all as individual categories. In the UK we always used to just used to stick to 4 main categories, PRBC, FFP, CRYO, PLT'S and some times Whole Blood if it was ever used. My issue with having lots of different categories is that all of these are presented to the Dr's at the time of ordering and they are unlikely to understand all the different product categories and know which one they should be selecting etc, so my gut instinct is to stick to the major types of product as the specific product type is in the description anyway defined by product code and there is little benefit to each one having its own category. Just curious what the usual setup is in the US? As we are going for AABB accreditation I want to set it up in a way that they would expect to see it. Thanks

In the past we always used to test the second group with just a forward group but when the requirement for 2 samples came out in 2012 most labs changed to doing two full's groups on the first 2 samples, then forward only on any subsequent samples. 4.3.1. ABO grouping. i. A full ABO group comprises a forward group and a reverse group; the forward group should be performed using monoclonal anti-A and anti-B blood grouping reagents, and the reverse group using A1 and B reagent red cells. ii. A full group must be performed on all samples from first time patients, with the exception of neonates, where the reverse group is unlikely to be helpful, as any ABO antibodies are likely to be maternal in origin. iii. Consideration can be given to omitting the reverse group on subsequent samples, where secure, fully interfaced automation is used and a risk assessment has been undertaken to ensure that the forward group is not compromised. The risk assessment should include the possibility that the first sample may have been taken from the wrong patient, an event estimated to occur at a rate of 1:2000 samples (Dzik et al., 2003; Murphy et al., 2004). iv. The following should apply before consideration is given to omitting the reverse group: • There should be no manual intervention or manual editing of results; • The current cell group must be identical with the historical record; • There must be at least one valid historical record where testing included a reverse group. The historical group should have been performed in a fully automated system, in control of the LIMS or analyser, with nomanual edits; however, further aspects of validity should be locally defined, with consideration given to where and when the group was performed and recorded. v. The risks involved with omitting the reverse group decrease with the number of matching historical records. Where there is only one historical record, the first sample could have been taken from the wrong patient, and a grouping anomaly in the subsequent sample could be overlooked without a reverse group, e.g. mixed field reactions (potentially indicating an ABO incompatible transfusion) are sometimes not detected or are misinterpreted.

I think the point is in an emergency situation where you don't have time to either get the second sample or if you have the second sample and have identified a discrepancy then you should use group O until it is resolved. What other option do you have? If it is not an emergency then of cause a third sample would be required to resolve where the error occurred as well as looking at any other patients on the same ward bled at a similar time to see if there are any other patients involved in the mix up. But I agree with your point that it should be all patients that have a second sample, we required 2 samples regardless of their blood groups.