Abdulhameed Al-Attas

I think your staff need to have a periodically check ups of vision and color blindness as part of the staff competences.

I agree with Malcolm,and I will add that Gel Column Agglutination DATs provide also a sensitive means for detecting mixed-field agglutination reactions. The reactions will look like a band of red cell agglutinates on top of the gel and a pellet of unagglutinated cells at the bottom of the microtube.

Microscopic readings are not required for routine antigen typing. Many labs do not read microscopically except in special circumstances, e.g., mixed-field agglutination (MFA) that may not be apparent with the naked eye. Reading is done on 4 - 6 fields using an inverted microscope. It is important to (1) make sure the cell button is totally resuspended prior to reading, otherwise agglutinates may remain in the button, with only free cells being read; (2) examine at least 4 - 6 fields, otherwise weak reactions or MFA may be missed; (3) read cell suspensions that are neither too heavy nor too light, otherwise weak reactions may go undetected.

Welcome Steve-You have really joined the best site for Blood Banking on the internet.

aafrin,that is a very good question. I am afraid I have no idea but let us see what our folks say.

In forward grouping we use Anti-A and Anti-B ,in reverse we use A cells and B cells ,The way you have reported is creating some confusions. I need to ask some clarifying questions. 1- what about your Ab.screening ? 2- what was the result of your DAT? if positive was it mixed field? 3- did you do a prewarm technique? 4-If what you have reported at the end is the patient's phenotype then what do you mean by k NOT K (+-) and Jk (a or ?

Welcome back!!!

You think you're special because its your birthday today. That's complete nonsense...... you're special EVERYDAY. Remember age is just a value; the higher the age the higher its VALUE. Wishing you a day that is as special in every way as you are. Happy Birthday.

The two signatures are as follow: 1- Patient identified and blood taken by and 2- Patient and blood sample identity checked and verified by. The supporting reference are in CAP - Transfusion Medicine Checklist.

Ditto.

We use BAC T/ALERT 3D automated microbial detection system,by bio Merieux,inc.

It is NOT written well,But you can sleep easy.

I also agree..to stop the Transfusion and do workup.

Malcolm,that was a very useful artichle,I completely agree.But I have to add one neglected point: Immediate Spin Crossmatch The Immediate Spin (IS) crossmatch is performed only after an antibody screen is done and found to be negative on a current specimen. The patient should have no history of clinically significant antibodies. The immediate spin crossmatch is meant to detect ABO incompatibility. It can also detect cold reactive (clinically insignificant) antibodies that react at room temperature (RT). If the patient's expected ABO antibodies are not reactive or weak at immediate spin,donor units should be ABO confirmed prior to testing with this method.

Landsteiner Heat (56°C): is NOTsuitable if the purpose is to elute antibody and save the red cells for antigen typing or for autoadsorption. The heat elution at 56°C denatures antigens.This method is mainly useful for cold antibodies or antibodies that react in both the cold and the warm, e.g., antibodies that cause ABO-HDN. It does not recover warm antibodies as well as the other methods but is relatively simple and rapid. The Modified Heat Elution( 40°C- 45°C): Unlike the regular heat elution at 56°C, the modified heat method uses lower temperatures that will not denature antigens. A disadvantage is that the DAT may not become negative until the temperature is so high that antigens may be denatured.

Malcolm,I am sorry to hear of the fire and I am all thankful that there were no injuries or loss of life. You are really an awesome! it takes a ton of courage and dedication to continue on after an event like this. I know it must have been a devestating experience. As best you can for the time being keep up the great work! I very much appreciate your wonderfully unique contributions to this forum and I am sure that all members of BloodBankTalk, wish you and your family a speedy recovery .

Yes,it is true the forward ABO group can serve as Rh control. The Rh control is necessary (especially in apparently group AB positive patients) and also An Rh control must always be run along with the weak D test. Always consult the product insert to determine if Rh Control needs to be run when performing the immediate spin D testing.

I enjoy learning as I also have too much to still learn from this wonderful Site. Although I am still striving to become a BloodBank Talk nerd,I am not one yet, so please count me in with your wanna be Nerds. I love this site.........and all of us we love you David Saikin and also our Professor Malcolm Needs.

NO further tests for the Abs.Screen,and by the way,This is a strange way of thinking! But the ABO discrepancy must be resolved by increasing the plasma ratio,4°c incubation or enzyme enhancement. The immediate spin crossmatch is meant to detect ABO incompatibility. It can also detect cold reactive (clinically insignificant) antibodies that react at room temperature (RT). If the patient's expected ABO antibodies are not reactive or weak at immediate spin,donor units should be ABO confirmed prior to testing with this method.

I vote for Thermo scientific Freezers,They are really wonderful freezers.

It is now clear that FNHTRs are commonly caused by cytokines, such as interleukin (IL)-1, IL-8, and tumor necrosis factor-alpha (TNFa). These cytokines are generated and accumulate during the storage of blood components. It has been proposed that an interaction between donor leukocytes and recipient antibody leads to interleukin-1 (IL-1) release from donor leukocytes or recipient monocytes. IL-1 can then cause fever by stimulating prostaglandin E2 production in the hypothalamus. Cytokine accumulation is reduced by prestorage leukocyte reduction,but bcause prestorage leukoreduction cannot prevent the accumulation of some biological response mediators in cellular components such as IL-8, C3a, and C4a, an additional approach to preventing FNHTR associated with cellular components may be to remove the plasma just prior to transfusion. Currently this strategy is not routinely used, although it has been shown to be effective in preventing severe reactions to cellular component,we have tried successfully several times.

Wellcome Kingkenny,You will,this is a wonderful site.

Similar to Galvania.

Similar to BankTech,an initial sample and a second one for ABO confirmatory,if Blood is urgently required then in that case give O Rh negative.

GEL METHOD The gel test was developed in Switzerland in the late 1980s as a way to standardize the method of obtaining agglutination and to provide a simple and reliable way to read it. (Lapierre Y, Rigal D, Adam J, et al. The gel test: a new way to detect red cell antigen-antibody reactions. Transfusion 1990;30:109-13 ) Besides these benefits, the test also provided a way to do antiglobulin tests without having to wash them. Also, the test uses small volumes of serum and cells and is capable of using automated reading. That is NOT everything,the Gel method is better than conventional tube method because of its Sensitivity,Simplicity and Stability of results,thus permitting reading and verification later on,its a rapid and innovative method for detection of antigen antibody hemagglutination reaction. The Gel card method testing takes 20-25 minutes as compared to 90 minutes by the conventional tube method. Gel Principle/Method Unlike in tube tests, in the gel method agglutination does not take place in a liquid phase but rather in a gel contained in a special microtube. Briefly, the method is this: patient plasma and a 0.8% suspension of red cells (e.g., screen cells) in a low ionic medium (LIM) are dispensed into the microtube and incubated at 37∞C for 15 mins; the card containing the microtubes is then centrifuged at a controlled speed for 10 minutes. At the start of centrifugation the cells are separated from the serum; then they meet the antiglobulin serum contained in the microtube; finally the cells are trapped by the gel (if agglutinated) or pellet to the bottom of the tube. THE PROCEDURE: A 0.8 % suspension of the donor’s red cells was prepared by mixing 10 μl of red cells in one ml of LISS (ID diluents). 50 μl of the donor’s red cell suspension is added to the microtube, followed by 25 μl of the patient’s serum. The card is incubated at 37°C for 15 minutes, then centrifuged in ID centrifuge and results read. No agglutination indicates that the donor’s blood is compatible with the recipient and suitable for transfusion. A negative reaction displays pellets of RBCs at the bottom of micro tube with no aggregates in gel matrix. The presence of agglutination is indicative of incompatibility. Positive results are graded for 1+ to 4+. A 4+ reaction isindicated by a solid band of red blood cells (RBCs) on top of the gel. A 3+ reaction displays agglutinated RBCs in the upper half of gel column. A 2+ reaction is characterized by RBC agglutinates dispersed throughout the column,while a 1+ reaction shows RBC aggregates in mainly lower half of the column. I hope this will help.