LaurieD

Hi Mabel, I agree. We do expect staff to be able to explain that the reactivity is truly due to a cold before applying prewarmed technique. In the case of an O patient that we suspect has a cold reactive antibody, we would perform the IS phase of a tube screen. Again, thanks for the responses. I find this message board extremely helpful Aloha- Laurie

Hi all, Thank you for your responses. I guess I should have mentioned that the antibody screen is negative. I actually had forgotten about anti-Vel and P,P1Pk (shame on me), but wouldn't we see a positive screen if either of those were present? I guess we could perform cold panels in this situation, to try to identify a specificity. @exlimey, poor Blood Bank of Hawaii actually does not have a reference lab currently (no staff), our larger facility in Honolulu (where my office is) actually performs more complex antibody testing than anyone else in the state. Our small facility on Hawai'i Island would actually refer any testing to us- if we are unable to tackle the situation, we would send to the ARC in California. We would definitely suggest a blood warmer for transfusion in this situation. Again, thanks for your responses! I usually just read through and look for guidance in all the posts, first time actually posting.

HI all- I have a question regarding dealing with crossmatches that are incompatible at immediate spin, yet compatible at antiglobulin. The staff had to perform a prewarmed backtype due to a cold antibody, so the reactivity at IS is likely due to this cold antibody. The antiglobulin crossmatch is compatible- however this creates a difficult situation since technically the unit is incompatible at immediate spin. The cold did not carry through to the antiglobulin phase. I would love to hear everyone's thoughts on how to approach this. This is a very small facility on the Big Island of Hawaii- they do not have a computer system, to assist with the ABO incompatibility check required by CAP. If the antiglobulin crossmatch were incompatible, it would make sense to perform a prewarmed crossmatch. We currently have them performing the second ABO reconfirmation from a different collection, and of course they reconfirm all unit ABO when they receive the units. Mahalo in advance for all your wise words