[Neonatal RBC Transfusions]

Is sickle cell testing required for an exchange?

[exchange transfusions]

What are the requirements for the unit of rbcs when reconstituted for an exchange to a neonate?

[exchange transfusions]

What the requirements for an exchange unit? Must it be washed, irradiated, and sicklecell neg?

[New Ortho Fetalscreen product]

Has anybody used the new Ortho Fetal Screen II? Any opinions, pluses or minuses vs. Immucor's?

We did a study comparing both and the staff did not like the Ortho product. The pos control was very weak and not what they have been used to.

[Cerner vs Sunquest]

We may be changing from Sunquest to Cerner. Has anyone compared or used both? We currently have a Provue and do perform electronic crossmatches.

[Biotest Reverse Cells]

We have noticed the B cell button first has the appearance of being positive, but after excessive shaking it comes off negative with patients who are type B or AB.

We routinely test our reverse cells daily for positive and negative reactivity. We use anti-D for our negative control with the reverse cell as they are Rh negative. This is the second month in a row that we have found reactivity with our A1 cells and anti-D. The negative control comes off very rough and when observed microscopically needle-like crystals are seen. Biotest tells me that there is only one other account besides us reporting this. I don’t know if others routinely perform a negative control with these cells. Perhaps you should consider doing so.

[Gel vs Tube discrepancy]

A blood sample from a patient with DIC and post dialysis gave AB on the tube method and O on the gel method. The patient is known to be O. Washing the cells did not change the tube results.

A sample a few hours later gave O on both methods.

What happened?

Thanks

Liz

I have had a few discrepancies between gel and tube. The Provue probe will sample blood from the very bottom of the tube. The blood at the bottom tends to be the freshest or heavier. So if the Rh pos patient was transfused with Rh neg recently you get the dual population of Rh or it will type totally Rh neg if there was a massive transfusion. Same thing would happen if the patient had received alot of another type. Tube testing is a big mixture of cells.

Also I have seen a difference between the Ortho reagent on the Provue and Immucor reagent used with tube testing.

[SCC SoftBank]

Thanks for your reply. How do you like SCC? I was very impressed. We currently use Sunquest. Are there any problems with SCC?

[SCC SoftBank]

We are looking a Soft. We currently have Sunquest. What system did you have before? I know this does not help your situation.

[feedback wanted on cost saving ideas]

DAT on cords- We quit doing this unless the physician requests it for some reason. We had routinely been doing a DAT and ABOR on babies born to RH + moms. We were continually working up ABO incompatibilities and Rhogam.

[feedback wanted on cost saving ideas]

Antigen screening- We screen units with the patient's plasma if the antibody is showing, then we antigen type using commercial antisera in the tube those that were compatible. If the antibody is not showing strong enough, you can use gel Igg cards or buffered gel and test units with the commerical antisera. Since we have not validated this in gel, we would confirm with a tube test.

2nd ABO type- I hope it is not a state requirement. We just went to electronic Xm and we do a forward type to confirm on the smae sample.

[Computer Programs for BB Quality/Variences]

I looked on the internet for MIDAS and cannot find anything. Where can I get the information on this.

[Computer Programs for BB Quality/Variences]

I use MERS-TM but I do not submit it to the website. I just clasify the variances this way. Check out their website.