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galvania

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galvania last won the day on November 28

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About galvania

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    Seasoned poster
  • Birthday 05/09/1955

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  • Interests
    Jazz, birdwatching, gym
  • Location
    Fribourg, Switzerland
  • Occupation
    teacher/BMS in transfusion science

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  1. galvania

    Direct antiglobulin test

    Well you carry on doing just that then klsmith, seeing as you had ONE example where it came up with something that would have otherwise been missed, and you clearly think that that justifies it. Actually why not put up enzyme IATs routinely as well. But please do not complain when you have to put up panels on 90% of your samples and get inconclusive results on all of them
  2. galvania

    False Positive DAT CAP Survey

    This issue has been going on for years. The complement coated cells are produced artificially. The method used is designed to be used to show positive reactivity with anti-C3 in a tube technique. It is not designed to show absence of reactivity in anti-IgG, neither in a tube, or even less in gel. Indeed the method used will ALWAYS show an unwanted positive reaction in anti-IgG if you use gel. CAP are aware of this - enough people have complained about this over the years. Why they don't do something about this is a mystery to me
  3. galvania

    Questionable blood types

    Except that we are talking about patients here that have anti-B in their own plasma already. We are not talking about patients who have no detectable anti-B in their plasma. So we are talking about a patient who groups as an A in the forward group and has a ++ reaction in B cells, due to anti-B. So if he receives group A plasma, yes, he will receive some anti-B - which will be diluted out by his own plasma which already contains anti-B……….. Realistically, I think it is a question of comparing risks, benefits and the amount of work. In this case, what are the chances that this is an ABwk patient? - Very low What is the risk, if this patient is an ABwk, of transfusing this patient with group A blood? None. On the contrary it is better than transfusing with group AB What is the risk, if this patient is an ABwk, of transfusing this patient with group A plasma? very little as the patient already has a considerable amount of his own anti-B in his plasma What is the risk, if this donor is an ABwk, of transfusing to a group A patient? Very little as the amount of B antigen present is so small How much work do you need to do to be 100% sure that this type of reaction belongs to a patient who is really a group A and not ABwk? As an absolute minimum genotyping, possibly complete sequencing. Long delays and $$$$$$$$$$$$$$$.
  4. galvania

    Direct antiglobulin test

    And never EVER , under ANY circumstances look at gel tests under a microscope or a magnifying glass - unless you want to call absolutely everything positive and waste everybody's time
  5. galvania

    Questionable blood types

    and you would - I hope - transfuse with group A, so if you wrongly called it a group A, rather than an AB, it would actually be better for the patient. I know of at least one case where an ABel was transfused with group AB blood and died as a result of a transfusion reaction. And if this is a donor, the amount of B antigen present MIGHT cause a minor reaction if transfused to a group A patient but would not do any serious harm. An what percentage of those weak reactions with B cells will actually be caused by this phenotype anyway? Probably less than patients having antibodies against LFAs that are not picked up in the antibody screen and who have a minor reaction due to the incredible bad luck of receiving a unit of blood that just happens to have the antigen
  6. galvania

    Questionable blood types

    I would just like to add another comment to this discussion. CAT is NOT the best method for looking for weak ABO antigens or antibodies.
  7. galvania

    Questionable blood types

    Yes, that's true, Malcolm. On the other hand, if you test with 2 different monoclonal anti-A reagents (and an anti-AB for good measure - a real one not an A+B) and they all come up 4+, I think it's fairly safe to say that the patient is a group A. I think that giving group O blood in this case is both wasteful of group O blood (unless you are swimming in it) and overkill
  8. galvania

    Questionable blood types

    Well if this is a patient, the worst case scenario is that the patient is actually an AB with an atypical weak B antigen that is not being detected and a weak anti-B in his plasma. So what would happen if you gave group A blood - nothing. If it's a donor, then you surely have the possibility to do extra work ups - but you would be unlikely to cause any harm if you called the donor a group A. And there are SO many reasons for having weak ABO antibodies - not least because we have the tendency to be too clean around our kids!
  9. galvania

    Bombay H/H1?

    HI sounds more like it.
  10. galvania

    Rh Pos or Rh Neg?

    I would just like to add one 'grain of salt' to this debate. You cannot detect all D variants - whether D weaks or partial Ds by serological methods alone. Neither D weaks or Partial Ds behave in a way that allow one to say that all D weaks or partial Ds react with such and such a strength. You will always miss some. You will miss some D+ donors because their D antigen is so weak that it is not detected by even the most sensitive of routine serological tests - or because despite using at least two different monoclonals the donor has an extremely unusual variant that is detected by neither. You will miss some 'D-neg' patients because they have sufficiently large numbers of D-antigen sites that they give a normal reaction with the anti-D reagents used. Follow the manufacturer's instructions for the reagent and method used and you will detect as many as you can hope to detect. And before you shoot the manufacturers because their reagent/instrument gave a 4+ reaction with a partial D known to have 10'000 D-antigen sites per red cell, and discovered because the lady made an anti-D and she is pregnant - please take a minute to think about the theory behind the serology. Maybe in years to come there will be a foolproof routine method for catching every single one……...
  11. galvania

    Ortho C-D Gel card versus BioRad Gel Card

    You make it sound as though the bio-Rad system does not pick up Kidd antibodies. I can assure you that just is not the case. If it were, then there would be a huge number of transfusion reactions in hospitals using the bio-rad system - and that is not the case. There may be all sorts of reasons as to why these particular antibodies are not showing up. First of all, can I suggest you try repeating manually. As this is a trial, there may be a problem in the way the instrument has been set up - although that is a long shot. Then, what I strongly suggest is that you contact your local bio-rad rep and let them send the samples to Switzerland. Switzerland will need to know exactly which lot of cells and cards you were using, they will want print outs of the results from the IH1500 - and as much information about the age of the sample, whether it was frozen etc as you can give them.
  12. galvania

    Ortho C-D Gel card versus BioRad Gel Card

    OK - to clear up some confusion (apologies for it being so late in the day!). Ortho in Europe has glass beads. Ortho in the States has gel which is similar to but not identical to the Bio-rad (ex-DiaMed) gel. As the original question was about Kidd antibodies, I will stick to that. You all know that Kidd antibodies love playing hide and seek. BOTH techniques will miss some Kidd antibodies - but not necessarily the same ones. So you might see some antibodies coming up in Ortho and not in Bio-Rad; and you will see others that do the opposite. And by the way, Immucor will pick up Kidd antibodies that no one else does but it's not sure that these are real but might be artefacts caused by Paraben. It is fair to say that some antibodies just 'prefer' one system over another. But across the board, it evens out.
  13. galvania

    Rh Pos or Rh Neg?

    You CAN trust the results in gel. But as with any technique you have to understand the theory before you can interpret them correctly. Same goes for all methods
  14. They may not be contaminated. The question is, are they working correctly? In other words, if you put up your controls, especially anti-Fya, are they working correctly?
  15. Hi Galvania,

    Do you have more information about cases of difficulty in adsorbing out allo-anti-Jra ?

    We have tried 6X adsorption still failed. Its reactivity like a HTLA.

     

     

    Emergency room

     

    1. galvania

      galvania

      unfortunately no more than the comment that I posted - that our reference lab reports difficulty too

      sorry

       

    2. emergency room

      emergency room

      It's ok. Thank for replying.

       

       

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