Bet'naSBB

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We might be the "Odd-Man-Out" - but, if the mom has an antibody and the DAT is negative on the cord sample, we don't test the plasma. If they order a neonate type and screen and the screen is negative, we don't give antigen negative units.............🙀................unless there is clinical evidence of hemolysis our Med Dir says it's warranted.

My question would be - how strong was the pre-transfusion reactivity? If it was only 1-2+ in SP / and the patient isn't a "larger" person, I personally would suspect that the antibody titer was diluted to such a degree that SP did not pick it up anymore....... (but I REALLY don't like SP.....it's just too wishy-washy.....JMHO)

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Not sure that there is a specific number. We just validated some Grifols antisera and ran 20 comparisons.

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At our facility, we have to do a cold adsorption IF the cold auto interferes with the reverse and/or ISXM. Since testing with "neat" plasma is our standard of practice, we would still report the XM as incompatible and send it out with a release stating the incompatibility was due to an autoantibody. We are not "allowed" to prewarm away IS reactions. 🥶 IF we prewarm - it's only if the cold has a high thermal amplitude and causes interference after 37deg incubation / antiglobulin phase...........but that's just us.........

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Once our patients show panreactivity in GEL, we automatically switch them to PEG screens which are negative 95% of the time. We stop doing gel all together. We don't test with DTT treated cells until the PEG screen comes up pos. Then, if the screen is NEG with DTT treated cells, we give K neg units with a signed release.

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when we see up the side reactions in gel (we call them train tracks) it usually ends up being a cold auto sort of antibody. we would run a DAT - Poly, IgG and Complement....... run a cold screen (IS, RT, 4C) most times the explanation is there in this kind of testing........... other reason could be rouleaux - either way we would switch to PEG here..........and notate in the patient's record to perform future testing in PEG.

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Would it be easier to look at what "complexity" of testing they have experience with? I know for our BB we prefer those who have experience with "High Complexity" testing over only "Moderate Complexity" or lower We would probably interview to get a better idea of "where" they are based on asking specific BB questions. We also state "Certified or Certificate eligible" Depending on the job being posted, we usually leave the experience out so we get some new grads to apply......who don't have experience - but we can train and we know the program they come from. For the more advanced positions, we would specify a certain # of years required in BB - which would be assumed to be a FT position whether it be BB specific or generalist with BB experience.

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