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galvania

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Everything posted by galvania

  1. galvania
    going back to the AIHA, I wonder if there's a warm IgA component in there?
  2. galvania
    And I would like to stress one thing. There is NO serological method that will allow you to detect ALL partial and weak Ds. Variant Ds come in all shapes and sizes. There are some weak Ds that have so few D antigens that the most sensitive 'normal' serological techniques will not pick them up - they will be typed as D- (including donors). On the other hand, some partial Ds have a sufficiently high number of D antigen sites that you will detect them as a normal D+ (even patients). And there are some Partial Ds that react with all commercially available Anti-D clones. So you will pull these up too as D+ (even for patients). The message behind this is - You WILL misgroup some D variant patients as D+ and you WILL misgroup some D variant donors as D-. And you have been misgrouping them for ever. Until (and if) genotyping becomes as easy, fast and cheap to do for every routine group, then you have to learn to live with it!
  3. galvania
    Oh dear, whatever happened to common sense? If you are testing an antibody screen, for example, why do you need a negative control? The majority of your samples will give a negative result. So you know that the negatives are working. But you DO need a positive control to make sure that the reagents are working. similarly, if you have an anti-k reagent, where are you going to get a k-neg cell to use as a control each time (in a normal lab)? For ABO, if you have an A, a B and an O you have covered everything, even the reverse group, as with the A and the B one of the reverse group cells will be negative each time.....
  4. galvania
    PT??
  5. galvania
    I know some labs who run an AC with their screen, AND with their panel, AND with their XM - which they do even if their screen was negative AND get very worked up if the results are discrepant - like between a negative result and a trace reaction that's there if you look through a magnifying glass. Personally I would only do an AC with my panel if everything is coming up pos.
  6. galvania
    You're STILL in that era. Genetics is discovering new things every day - not just about blood grouping either
  7. galvania
    Sorry - who is talking about warm sand? But whatever - everything has to be 'validated' nowadays. Regardless if it makes any sense or not
  8. galvania
    We used to do the same. I remember we had one patient whose cold aggs were so strong and had such a high thermal range we had to wheel her into our 'warm room' (a small room where we used to incubate all our microbiology stuff) to be bled for any tests. And we had to bring small bits of equipment into the room as well. But then I'm going back a very long time and tests were very unsophisticated then compared to now. Can't quite see that happening today, somehow
  9. galvania
    Can you hear me groaning ?
  10. galvania
    Weird.....Why did they order the lectin work up anyway? doesn't really look like a polyagglutinable sample from those results - but i don't have very much experience with lectins I think I would be inclined to do an antibody screen in the cold (thinking auto-anti-I or -i)
  11. galvania
    But look on the positive side. If you are seeing a discrepancy, this should alert you to the presence of a variant that you might not have known was there otherwise
  12. galvania
    Why do I get the distinct feeling that someone is not giving you the full picture on this one....???
  13. galvania
    Do your commercial ABO cells come from the same supplier as your screening/panel cells?
  14. galvania
    This is SCARY. What tests were carried out leading up to the transfusion in the laboratory?
  15. galvania
    I too would go for an antibody outside of the ABO system, active at RT that was present on the original A1 cell. If this A1 cell is from a single donor, that makes it even more likely. As Yan Xia said above, if it's a pool, then you might well see a mixed field. So I would test against (as Malcolm says) at least 4 other A1 cells; and I would test the original A1 cell also at 37°C to see if you are looking at something you need worry about or not
  16. galvania
    Keep trying Scott. we're with you
  17. galvania
    I understand that it is easier to draw the bloods when the patient comes in for pre-op, maybe many weeks before the actual op. Can I suggest that what would be sensible would be to bleed them then for a T&S - this way you will be prepared in case the patient turns out to have anti-nasties (this is a new scientific term coined by me as it's Friday afternoon); and then to bleed them again when they come in for the op - you will be then within the time delay as well as avoiding the patient having to come in three times (pre-op, 3 days before op, and for op); but still in time to react if there is a change between the two samples
  18. galvania
    There is clearly a problem here. If you did a titre on a D+ cell and it was 512 then the antibody should be coming up quite strongly positive against ALL D+ cells unless...... 1. this is not an anti-D but another antibody and you were just lucky that you hit the spot when you did the titre (or maybe a weak anti-D + an anti-LFA) 2. Technical error during the titre 3. technical error during the 'quick few D+ cells on mum 4. Mum has been plasmapheresed inbetween you doing the titre and the 'quick few D+ cells 5. The titre is actually now higher than 512 and you are seeing a prozone effect I suggest you re-test the cell you used for the titre, plus do a panel - and look for anti-LFA
  19. galvania
    So you put them in a tube, but you don't centrifuge them. Is that right? If so, look at the cell pellet at the bottom of the well. In my experience, not centrifuging the segment can mean that your suspension is weaker than it would be if you were using a spun patient sample (or the reagent red cells) because your 5ul is not 5ul of packed red cells. when weak reactions are involved, a weak suspension can make a weak positive reaction look negative. This could mean that actually the crossmatch results were falsely negative
  20. galvania
    What do you do with the segments BEFORE you take the 5ul?
  21. galvania
    Yes I agree Malcolm. I was thinking more of some of those reactions you get that are a bit 'iffy' in a panel in gel - which is extremely difficult to do at strictly 37 - and you just need an aid in identification
  22. galvania
    And just a practical tip. Best way to detect most anti-M is in an IAT with incubation at 20°C rather than 37°C. No references for this, just lots of practical experience
  23. galvania
    Sorry mrmic, but I have to disagree with you. Gel testing is not just a miniature tube method. Especially when you are talking about any reactions relating to AHG. The principles behind testing are really quite different.
  24. galvania
    I guess there is no possibility that there were free red cells in the platelets? Also, was the patient given anything else at the same time as the platelets? It may be that there was a transient reaction between two different things both being administered roughly at the same time, and that the complex 'stuck' on to the red cells for a while???
  25. galvania
    OK, so I presume you are diluent 2 to make your crossmatch suspensions? Well, Diluent 2 is not identical to the buffer used for the cell suspension in the screening cells. so it may be that this patient is reacting against something in the red cell suspension buffer which is common to both biorad and Capture - although I have never seen one reacting that strongly before. On the other hand, it certainly does look like a cold antibody. Are you doing both screen and XM manually or on an instrument? And how exactly are you preparing your blood bag segments?
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