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galvania

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Everything posted by galvania

  1. Or was the K_B positive because mum had high levels of HbF and therefore none of the injected anti-D 'used up'?...... Butlermom - where are you??????
  2. Also how strong is her anti-D at 6 months and by what technique?
  3. ..........and on the result of the reagent control you put up with it and what is wrong with the patient, if it's a man or a woman,and how old................and why you were doing the test in the first place
  4. galvania

    Retired

    oh my goodness. You poor thing. You have really been through it. I admire you for your strength. You are very brave
  5. I would just be a bit suspicious if say there was a + reaction with A1 cells and 4+ with B cells in an apparent group O - or vice versa; or very weak reactions in a young healthy adult.....a bit of common sense required, that's all
  6. or mum is a surrogate or baby is the result of an ivf with external donors
  7. to be fair techniques in the early 80s were not what they are today, neither for blood grouping nor for antibody screening/identification. Methods were not standardised. The number of drops of serum (almost always serum) to the amount of red cells could vary from 2:1 to 8:1. The concentration of the red cells could be anything from about 2% to almost 10% - and often pooled. And pooling was one of the main reason for checking under the microscope. Incubation time varied too - often depending on the length of your coffee break or lunch break. LISS was in its infancy. Washing was done by hand or with a 'Coombs washer' - 3 or 4 washes, with or without albumin. So perhaps not surprising that people were not too confident in their visual results. Much less knowledge then too about what was and what was not clinically significant. (I can remember when we treated cold anti-A1 as clinically significant) Thankfully since those dark ages things have improved massively - but sometimes some of the old habits stick - like using a microscope to read apparently negative results. The practice lives on (in some places) but the reasons for that practice died out long ago
  8. true. Should have read that more carefully. Well the answer is still - yes and no. If you are using monoclonal reagents, and assuming the anti-D has the same formula as the other reagents (barring the actual antibody obviously) then most results will have at least one negative well that can serve as a control in any case. You could just then put up a neg control on the AB+ results. But the majority of cards/cassettes do have a control on them anyway. If there's only anti-A-B-D, that's only supposed to check a group that is known i.e. has already had at least one full group with a control. But there too - only a problem if AB+. And if you are using an Rh pheno card, the control well on the grouping card is valid provided that the formula for all reagents is the same
  9. well yes and no. It would depend what the test was. The typical test not offering controls would be an antibody screen. As most of these are negative or positive with only some of the cells, this acts as its own control. Where you would need to perform a 'negative' control is if all screening cells are positive. This would be done by carrying out an auto-control with the panel. If that is positive too, however, you still won't know, in the absence of any other information, whether the patient has a true auto-antibody or whether the patient is reacting because of the potentiator in the AHG / diluent. For antigen testing, a must however, especially if tested in an IAT or with enzymes
  10. of course it could just simply be that the hospital lab made an error grouping it as a false positive. As this is a question designed for new students, I doubt whether the level of scientific understanding required is very high at this stage. It would depend what theory the students had done up until the point that the question was set
  11. Three to four a week out of how many tests? Where are you getting your cells from? Is the reaction strength the same with all cells? Are you working manually or with an automat? Have you noticed a correlation with these patients' ABO groups? Also do you have any lookback as to whether the babies of these women were jaundiced or anaemic post delivery? Or were they OK?
  12. That's awful Frenchie. So much for all the talk about our 'valued public service workers'.
  13. you pretty much have to be retired to have used it routinely. Like me. And Malcolm
  14. Do keep us updated. I am sure we are all looking forward to news of a healthy baby
  15. Can I just point out here that no one serological test, or even combination of tests will detect all weak / variant Ds . And that includes women who test D+ but actually have a partial D and may make anti-D antibodies. It is SO important to know your reagents, and know what your anti-D reagents will and will not detect
  16. Sorry all, I replied on the other channel before reading all the above. ……...
  17. First of all, please do not worry. IF you do have anti-D antibodies, and they are real antibodies, this is only one of a number of tests that the doctors will do during your pregnancy to make sure everything is going OK with your baby. What they should do is recheck your blood for anti-D levels now and again in about 4 weeks' time to see if there is any change. It will show anti-D because of the Rhogam, but the important thing is to see whether the level increases significantly over time. Also, even now, if it is very high (VERY unlikely) then that would indicate it's real anti-D as opposed to the Rhogam. Ultrasound is a good idea. It is usually done anyway during pregnancy, but it will also show if something is happening that they need to react to.
  18. Apologies for not answering earlier. No, I did not mean 12 cells in the screening cell panel. I meant putting up 12 different antibody screens (12 different patients) each using a three-cell screening panel. Putting up = testing
  19. 1. did you think to do a DAT on the posttransfusion sample to see if the antibody was all 'stuck' on to the transfused red cells? 2. What method did you use to K-type the units of blood? did it involve an IAT? If so was the positive result a false positive because the unit had a positive DAT?
  20. sorry for the late reply. What I meant is that one tends to put up a batch of antibody screens. In the time taken to put up say 12 screens the cells can cool down enough for a cold anti-M in the plasma to latch on. On the other hand, panels tend to go up one at a time (1 patient at a time) so cells have less chance of cooling down. (Always assuming the screening cells and the pane are from the same manufacturer and being tested in the same method)
  21. In my case, temperature, as the screening cells and panel were both from the same manufacturer, therefore the same buffer system
  22. Because I've seen so many of them…………. But actually if your panel is not in the same buffer then pH or ionic strength could be the culprit rather than the temperature. Important to stress that these cold anti-Ms (in that they dont react strictly at 37°C) have no clinical significance. If it happens again, you can try the following: 1. Repeat the panel, incubating for 15mins at RT (on a Coombs card). The results will be stronger in this case. AND 2. Repeat the screen in the following way. Warm the cells to 37°C (best just to use a small aliquot - you dont want to 'cook' the whole bottle). And put the Coombs card (foil still on) in the incubator for 15mins. Put the patient's plasma in the incubator. IN the incubator, pipette 50ul of cells into the appropriate wells followed by the patient's plasma. Incubate for 15mins. At the same time, start the centrifuge empty. This warms the centrifuge up a bit. After 15mins put the incubated card into the centrifuge which will have now stopped and centrifuge immediately. This should negativise the screen results. This is about the nearest you can get to doing a gel test at strictly 37°C
  23. and what is wrong with this patient? what drugs is (s)he on?
  24. It depends a bit on how you work. If you are working manually then it is quite common to pipette a whole series of tests . In this time the cells can cool down enough for the anti-M to latch on, and once it's on it stays on. On the other hand, panels tend to go up individually so the cells stay warmer
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