Volume-reduced platelet concentrates (PCs) can be a useful option for transfusing a high number of platelets in the smallest possible plasma volume, especially in neonatal and other pediatric patients. In addition to decreasing the risk of circulatory overload, volume-reduced PCs contain less plasma, which may reduce the likelihood of adverse plasma-related transfusion reactions.

• Low-incidence antigens are not usually found on screen cell and antibody panels.

• Antibodies are hard to test for, but it is usually not difficult to find compatible blood.

Suspect this antibody if an AHG crossmatch is incompatible and other causes have been ruled out, such as a positive donor DAT or ABO incompatibility.

Examples of low-incidence antigens include: C^w, V, Kp^a, Js^a.

When going through the process of Ruling Out, antibodies like anti-V, anti-C^w, anti-Lu^a, anti-Kp^a, and anti-Js^a usually fall into the "unable to rule out" category.

 I have also never seen a case of ABO HDFN in a non group O mom which is severe enough to warrant clinical intervention in 30 years.

Testing

Yes, as Terri has mentioned the Medical Director is the one who interpretes the Transfusion Reaction,so untill he/she interpretes NO further Transfusions.

And we put a note for that to alert coleuges.

The reaction could be from Anti- IgA that requires either IgA deficiency blood or washed RBC's OR  FNHTR that may require Leukoreduced or HLA match in case of Platelets. 

It depends the reason for transfusion if it's to restore coagulation factors my answer will NO because of compromised coagulation factor activity,namely factor V and VIII.

What about if you get your SBB from Gulf Coast Regional Blood Center just for $ 3,000 per year ( 12 Months ), here is website http://www.giveblood.org/education/sbb-distance-program/ and then go to GW for Master of Transfusion Medicine  NOT Lab Management for $ 12,000.

I report as < 1:1

Anorris, I am afraid your report looks like a dilution rather than a titer.

We  ONLY irradiate the Cellular Components, FFP and Cryoprecipitate are NOT cellular components.

too weak to titer, I agree with Eagle Eye.

I have 30 years of experience. I agree 12 - 18 months for Tech. and about 2 years for supervisor.

The ABO/Rh confirmatory policy has been developed to prevent transfusion from a misidentified sample.

Our guidelines states unless electronic patient identification systems are in place, a second sample should

be requested for confirmation of the ABO/Rh group of the first time patient prior to transfusion, where this

does NOT impede the delivery of urgent red cells or other components.

 

The ABO/Rh confirmatory is a STAT test and should be handeled accordingly, it must be from a seperate collection phlebotomy and collected at a different time from the initial one.

 

It should NOT be a retained sample from the initial collection and delivered as a second one after Bank Bank calls for a ABO/Rh confirmatory sample.

 

Yes,post 4 months of age, we require a confirmatory sample, as MAGNUM stated.

We must always remember that the most important test done in the Blood Bank is ABO grouping. 

 YES, 24 hours, at Room temperature and without agitation.

I agree with both David and Anna for their respective suggestions of an enzyme pretreated panel in gel and extended phenotype on the pre-transfusion sample.

You have done an elution on the patient's post-transfusion red cells, and the resulting

eluate tested for antibody specificity.

Note  that in this case, even though the antibody elutes from the patient's red cells, it is NOT an autoantibody as it actually eluted from the donor's red cells now in the patient's circulation.

My heart goes out for all the people affected by this earthquake.                                Nothing is more beautiful than seeing people from different countries and cultures showing so much love for one another.

REMEMBER always THE ONLY WAY one can prevent graft-versus-host disease

is through IRRADIATION.

Irradiated Blood Products

All pediatric cancer patients will receive irradiated blood products in order to prevent

transfusion related graft-versus-host disease.

Filtered Blood Products

All pediatric cancer and sickle cell patients will receive filtered blood products. Filtration

is an effective way to eliminate the risk of CMV infection in patients with cancer, and

prevents alloimmunization.

CMV Negative Blood Products

CMV negative blood products will be reserved for cancer patients who are documented

to be CMV seronegative and are scheduled to undergo a bone marrow transplant. At the

time of transplant, these patients are more immunocompromised, and the low level of

CMV that may remain in a filtered product can still pose a risk.

Platelet refractoriness will be defined as inadequate rise in platelet counts as measured

within 1 hour of platelet transfusion.

Approaches to platelet refractoriness:

1. Make sure platelets are ABO compatible.

2. Ask for fresh units.

3. Test for HLA antibodies and platelet specific allo-antibodies.

4. Consider IVIG (0.5 gm/kg) and Amicar in patients with significant bleeding.

 

REMEMBER always THE ONLY WAY one can prevent graft-versus-host disease

is through IRRADIATION.

I hope this will help.

 We do vitals:  pre, 15 min, hourly, and post.

Welcome to this wonderful site.

 

We do not.

Wellcome to PathLabTalk,it is really a wonderful site!!

I would rather hypowash and do an extended phenotype of the patient and then transfuse RH and K matched Blood.You always need to verify what is done else where.

Titre: The reciprocal of the highest serum dilution that causes macroscopic agglutination when serial dilutions of an antibody are tested against selected red cells.

Applications:

Prenatal testing 

Identification of HTLA

Comlex Antibody Identification 

Differentiation of pathological and harmless autoanti- I  and  Procurement of antisera Quality assurance of reagents.

 

Limitations:

Titrations are only semiquantitative estimates of antibody reactivity due to several variables that affect their performance. Three main variables are the technologist, the red cells, and the method.

Ways to Minimize Variables:

1. technologist: experienced with proven technique
   
2. red cells: ideally when titres of samples are to be compared, use fresh red cells (antigens deteriorate on storage) from the same donor (same number of antigenic sites present). If this is not possible, use commercial red cells of the same apparent genotype.
   
3. method: when sequential samples are examined for change in titre, store samples frozen and run new samples in parallel with the immediately preceding sample. This is the most practical way to control that an increase in titre is real.
   

Prozone Phenomenon:

This may cause reactions to be weaker in the first tubes than in higher dilutions and is believed to be caused by an antibody excess in which all antigenic sites are sensitized with antibody leaving none free to form cross-links

Significant Difference in Titres:

When comparative studies are done, such as in prenatal testing, a difference in titre of at least 2 tubes is required to be considered a significant difference. For example, if the titre changes from 32 to 64, this is not considered to be significant (difference of only 1 tube); however, a change from 32 to 128 would be significant (2 tube difference).

These are the important points to know about AntibodyTitration.

Ditto, Donna

As Anna, mentioned above ''You need to use a control that is equivalent to the reagents you are controlling''.

that is to say, from the same manufacturer of your Anti-D. The Rh control contains everything that is present in the anti-D typing sera except the anti-D.

If Rh control is not available then you can use from 6-8% Albumin Because the Albumin added to the Rh control is about 6-8%. And as David said above,The control is necessary (especially in apparently group AB positive patients).

Another application is to use as a negative control when testing a Du or Weak D.