Mabel Adams

Maybe you can identify 3 employees who meet the typing criteria willing to give you blood when you need it. Might be some regulatory hurdles to that nowadays though.

I think I recall this number is more like 60%, although maybe that was of those transfused, not pregnant.

What we do might depend on if I am here and see the reactions or if I am handling it by phone at 2 AM. I have had calls where what I heard them ask was not what I found when I got to work the next day.

We scan them into the chart and keep the original copy in blood bank for those still done on paper. Now we mostly use the documentation in the EMR as the "signed" record.

If the forward type were at all weak, I would worry more about a false positive there which would be a problem but with a 4+ the forward type is more accurate. What we often do is call the patient A pos (this keeps the computer happier for one thing) but give O blood (put a note/special need in the computer to give O blood for now). Once we type this patient several different times this way, we might be willing to give A blood. If it's not going to deplet the O blood supply, we might stay with O.

If your patient doesn't type as O, then the old card can't mean anti-H. And a Bombay patient wouldn't lose their anti-H and have a negative screen now either, I don't think. Anti-HI (sometimes written IH) could likely have been identified back in the 80's when some places still did more room temperature testing. Anti-HI might have interfered then but with a negative screen you needn't worry about it now. The anti-Fya needs to be honored, of course.

Could that be IH or HI?

We issue only group O red cell products to patients for whom we have only one blood type on record. Although I have never seen the FDA look at that aspect of our procedures.

Category III partial D's are known to type just like regular D positives but are capable of making anti-D right? There is no perfect test for who can make anti-D and the nomenclature is a confusing mess!

I need to know what companies market software applications for doing data mining and management in the US for blood utilization and benchmarking. Thanks for any suggestions and information.

Is your pathologist also worried about all of the antibodies to low-incidence antigens that aren't present on your screening cells? Although I've not heard reports of any clinically significant transfusion reactions to those, they are also theoretically possible and missed by not doing AHG crossmatches for all units. Maybe some information like this could be used to "calibrate" the pathologist's worry meter. The fact that the Brits have not had any reports of patient impact to make them change their national policy might serve as a sufficient "research study". Nothing in this business is perfectly safe.

Is anyone else having problems with screen cell 2 on Ortho 0.8% screening cells lot VS155 being positive about 1+ with quite a few patients? Then when panel A VRA313 is run, it almost looks like an anti-Leb but cells 6, 9 & 10 that it reacts with are all HLA pos and we can rule out anti-Le b with a panel B cell. Of our seven patients, at least 2 have also reacted with cell 2 on the panel which makes me think panel cell 2 is also HLA pos, just not labeled as such. If you are seeing this, can you please report it to Ortho so they don't ever use this donor for a screen cell again? All of the usual specificities are ruled out in these cases. Most of the reactive samples are prenatals.

We have been trying to buy a new serological centrifuge but the Clay Adams is backordered for months. All of the vendors keep suggesting others that they think will work. We have already tried a Hettich EBA21 and just can't get it to work as well as the old Clay Adams. We get different results on titers using the 2 different centrifuges. Cell suspensions that are washed in it end up mixed once the braking stops. If we set the brake lower, it takes too long to stop. Is there a good serofuge for sale in the US anymore? I miss the Immufuges of 1985.

We use the CDC guidelines for the pathologist to interpret the reaction workup, not for nurses to determine whether it is a suspected reaction needing workup--not that they shouldn't have such information available. We also quote the JC standard in our procedures that says the workup should be performed if it meets our criteria "regardless of whether the physician deems it necessary".

Once the interfering drug is gone, we would treat them like a usual patient with a negative antibody screen. One caveat is that our BBIS won't allow an EXM for any patient who has ever had a positive antibody screen reported. If we ever reported the initial screen as positive instead of the DTT-treated screen (negative, I hope) we would have to do future XMs by IS rather than EXM. If we knew the patient would go back on it, I suppose we might give K negative units but most that I have seen go off of it didn't go back on and, frankly, most expired within a few months. This experience is mostly from the early days when it was only approved as a last resort therapy so now less refractory patients are taking the drug and may have different outcomes.