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Lone Snail

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  1. Training Specimens
    Procedure For Making Student Specimens

    Is there a way to make a fake Lui Freeze ?

    Do you have collect cord blood samples?  Cord red cell samples from A or B babies of type O moms (with pos DAT not due to other alloantibodies) can be preserved in Alsevers for nice student project samples. I've faked samples for immediate use by combining A or B cells from donor segment samples with type O plasma. I wash some of the excess plasma away before I give the sample to the student to work with. I don't have a specific recipe - just add a splash of plasma to cells from a couple of segments, then check a drop for a pos DAT.


  2. Training Specimens
    Procedure For Making Student Specimens

    amym1586, on 22 Jul 2014 - 5:19 PM, said:

    Is there a way to make a fake Lui Freeze ?

    I start off my students doing a mess of typings on random "just in case" tubes from the main lab about to be discarded - CBC and coag tubes. You don't need to do 40 typings to learn how but this also gives them good practice making suspensions, reading reactions, figuring out which end of the pipet to hold etc. Save the specimens. Next day, I tell them they will do one typing that will take all day. I show them on paper what they would have done to get to that point: O on front type, A or B on back type, couldn't get that "missing" back type cell to react with a cold back type. You should have plenty of O and A specimens, maybe a few B/AB. Make pools of each type and wash. To make your weak "patient sample", spike 2-3 ml of washed packed O cells with 10 drops of A or B cells. They also do the procedure on straight O and A (or B) cells. It works with either human source anti-A or -B (saved from the previous day's specs) as well as reagent monoclonals. I probably should spike the mock patient sample with fewer cells as you will probably adsorb out all the antibody, but they get the point and I want it to work.

     

    Other student stuff:

     

    A2 or A2B with anti-A1: spike a real A or AB serum with reagent anti-A1.

     

    O with weak anti-A+B: make a 12-tube serial dilution of O serum. Test each dil against A and B cells in the cold. Find the dil that gives you a w+ or 1+ in the cold. Make sure that dilution is not reacting at IS. Make up more of that dilution and give them O cells and that for their typing - the goal will be to get them to do a cold back type.

     

    Typing with unexpected abs in serum: Spike your serum with reagent anti-c etc or a patient ab that will react at IS. 

     

    Review your panels often. If someone has an antibody, scrounge up the stored tubes, even coags, from other depts if they save them, then pool and freeze to torment future students down the line. Freeze some specs with nice rouleaux.

     

    Make DAT positive cells for eluates by adding reagent anti-D to Rh+ cells as others have suggested. Our QC reagent ab has anti-A, -B, -D, -c. After the kit ODs I use it to get a "panagglutinin" by sensitizing D+c+ cell, or auto-anti-c by sensitizing D- cells.

     

    Transfusion reactions: Add 1 drop check cells to 12 or more drops non-coated cells to give mixed-field agglutination.

     

    I teach PeG autoadsorption by starting them with a pseudo-patient with the above "panagglutinin" on cells and in serum. They then use some frozen samples with anti-K and a couple of old CBC tubes that I've typed and are K- for their patient serum/plasma and cells (there's no "autoantibody" in the sample now but they'll never know that).

     

    Take advantage of fresh real specs when you have them (known weak Ds or weak subgroups), and in particular freeze specs with cool stuff like and-Sda or RG/Ch that you can do urine or plasma neutralization with.

     

    I also take them to watch a unit being hung, show them our QA process, involve them in audits and whatever periodic QC comes due while they're in the dept.


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