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RichU

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    Isle Of Man

RichU last won the day on March 2 2023

RichU had the most liked content!

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  • Gender
    Male
  • Biography
    Worked in RCI NHSBT for 20years. Took the opportunity to move to the Isle of Man Hospital Transfusion when it was confirmed that the centre I worked in was going to close and I didn't want to commute twice as far to the new Centre or go on to 24/7 shifts.
  • Location
    Isle of Man in the Irish Sea
  • Occupation
    BMS blood transfusion
  • Real Name
    Rich Ullyatt

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  1. If the patient has had a recent transfusion, elution studies might show if the antibody coating the cells in the patient's sample has a specificity. Red cells with the corresponding antigen should be avoided unless you have previously typed the patient and can say whether it's allo or auto.
  2. I just answered this question. My Score FAIL  
  3. Ah ok. Makes sense. Cheers
  4. How do you know a positive screen isn't caused by an alloantibody underlying the prophylactic anti-D unless you do an ABID?
  5. Jsbneg raised the elephant in the room!
  6. The same phenomenon is seen if you use a spun sample for DATs. The cells at the top can be negative and the ones from the bottom positive if recently transfused.
  7. NHSBT routinely perform IAT and enzyme IAT using BioRad LISS/Coombs cards. (Anti-IgG + C3d). I found this helps identification with some weak antibodies or where there is a mixture and one is enzyme sensitive. At my current hospital we still perform enzyme panels on NaCl cards. There are less reactions with antibodies we don't wish to detect. Of course you can't use enzyme techniques alone when identifying antibodies so it's a choice between; improved identification and detecting more insignificant antibodies (enz IAT) or Detection of fewer bothersome antibodies but harder to ID some cases (enzyme). Maybe use IAT and enzyme routinely and employ enzyme IAT to help solve tricky/weak examples? You would have to do some kind of testing/documentation/risk assessment etc. if you're not following manufacturer's package insert I assume.
  8. BCSH guideline for the use of anti-D immunoglobulin for the prevention of haemolytic disease of the fetus and newborn states 'Anomalous or indeterminate cord Rh D groups should be treated as D positive until confirmatory testing is completed.' For neonate transfusions see Malcolm's answer.
  9. I used this case study as part of my Higher Specialist Diploma in Blood Transfusion. The IBMS have asked if I would like to give my PowerPoint presentation ('What the f?') at the 2023 Congress. Thank you to all the contributors - I will certainly big up PathLabTalk if I do get to do it. Rich
  10. Is this in case the sample tube was not actually from the donor who gave the unit? If that is possible I would have greater concerns regarding the validity of the grouping and antibody screen!
  11. I guess low titre anti-A and anti-B. We don't have any whole blood. The usual major haemorrhage pack provided is 4 red cells and 4 FFP for transfusion in 1:1 ratio. During the TT motorcycle road racing we keep a box of 2 O neg red cells and 2 group A FFP for immediate use. This hopefully gives us time to test a sample and issue group specific if further units are required.
  12. When I worked for NHSBT RCI we kept the cells used for XM in Cellstab (containing preservative) for about a week. All our serology was performed manually so we had already taken an aliquot of cells which had been washed in saline before making suspensions. (Usually in Dil2 or BioVue's equivalent)
  13. We use DiaMed tech. Manual work is read using the Banjo card reader. Reagents are all scanned into the IH.com software to give a full audit trail - user, batch numbers, expiry. Unless the QC has been performed (identical to the analyser) and read the results have a QC watermark across them.
  14. We regularly used to run RT or even cold gel panels (LISS cells on Saline cards) to id M, P1, Le etc. If suspected A2 patient with anti-A1, use A2 cells in the reverse grouping card. We would test the grouping cells for the identified antibody. WARNING! These may require a degree of skill as may have to perform manual testing.
  15. Just an observation.... When I worked in a reference lab in the UK we tested the patient's cells against AB serum in parallel when performing IAT typing. This was part of the testing protocol and there was no DAT required. I would only think about doing a DAT if this negative control was positive. Is there a charge for running a monoclonal control with monoclonal typing reagents?
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