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ckcheng

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Everything posted by ckcheng

  1. Check the patient's A/G ratio and ESR give you a faster way if you suspect rouleaux. A2 patient with anti-A1 also possible.
  2. I have a case with all 3-cell screen positive (2+) in antibody screen. ABO & Rh show discrepancies which requires warm saline-washed red cells for red cell typing and prewarm plasma and A1 and B cells for reversed grouping. Potent cold antibody(ies) is suspected, so warm saline tube technique is used to repeat the antibody screen, it gave negative result. Questions are: (1) Should I report it as cold antibody(ies) or cold autoantibodies? (2) Do I need to perform cold autoadsorption, cold agglutinin titer, or other tests before I conclude it is a cold autoantibodies? (3) What is the different between cold antibody(ies) and cold autoantibody(ies) in an antibody workup report? Thanks.
  3. Patient's red cells has no reaction against Anti-A,B (actually most anti-A reacts with Ax cell nowadays). Group O cells was included in reverse group (increased serum to cell ratio, and 4C incubation to avoid any cold auto-antibody interfere) during interpretation. Yes, you are right that monoclonal anti-A is not suitable in the absorption and elution study cuz IgM don't react with AHG. Thank you very much for your help. CK
  4. The patient is a middle-aged gentlemen. Neither a transplant nor an oncology patient. Sent to hospital because of pneumonia. Strange was the big grade different in the reverse group. Under what situation should I suspect it is an Ael subgroup? Thanks.
  5. Please see the ABO discrepancies (reaction score 0 - 4+) below: Gel reaction: Forward: Anti-A: 0 Anti-B: 0 Reverse: A1-cells: 0 B-cells 3+ Tube method: Forward: Anti-A: 0 Anti-B: 0 Reverse: A1-cells: w B-cells: 3+s Increased serum to cell ratio and incubated at RT: A1-cells got 1+ Since there is a big grade different between A1 and B cells, should we suspect it as an A subgroup? or use 4C or enzyme to enhance the A1-cell reaction? Thank you very much.
  6. Thanks for the comments. However, since computer system is not developed or during downtime, the only way we issue blood is via immediate spin, if there is a running out of plasma to perform immediate spin for final checking of the blood group, how can I issue group specific blood for transfusion, cuz I can neither put [iS -compatible] nor [EXM - compatible] in the crossmatch form. Thanks.
  7. I would like to know some current practice of T&S, IS crossmatch. (1) Do you retype the patient's ABO/Rh if there is no historical blood group? (2) Do you recheck the donor blood with a segment attached to the blood bag? (3) In case of massive transfusion, and running out plasma in the sample tube, would you shift back to unmatch using Group O red cells even the patient is Group A or B? (4) How do you issue blood to neonate? Since you might not have sample to do immediate spin? Thank you very much.
  8. Hi, does anyone has a blood smear examination training protocol or checklist which can email me for reference? Thanks. Here is my email: ccckz01@yahoo.com
  9. Hi, does anyone has a blood smear exam training protocol/checklist which can email me for reference? Thanks. Here's my email: ccckz01@yahoo.com
  10. Sad to hear that. He did contribute a lot in the transfusion medicine!
  11. Agree with Malcolm, also think the patient is Fy(a-).
  12. extend T&S for outpatients is different from inpatients. Additional things need to consider, besides no transfusion in 3 months, negative Ab screen (both historical and current) and not pregnant, are (1) same patient when come back weeks later? (2) able to keep the original crossmatch sample 7 days after the transfusion? CK Cheng
  13. Thank you very much for the comments. I think it is a habbit to look for any weak reaction if macroscopically negative, (except red cell typing or techniques like LISS or PEG) and report weakly positive if microscopically positive. Yes, read under microscope also help to resolve ABO discrepancies in some cases, rouleaux vs real agglutination, mix-field reaction, .... etc. Agree that one may choose to spread a tiny portion on a glass slide and read under microscope. Also, thanks barmotto for the website. Thanks. CK Cheng
  14. Hi there, anyone knows where can i buy tube holders which use it to read DAT or IAT under the microscope? Thanks. CK Cheng
  15. Agree with cthherbal that Blood Group Antigens & Antibodies: A Guide to Clinical Relevance & Technical Tips is a good book. It is just like an abridged edition of The Antigen Factbook. Antibodies are in alphabetic order with brief description. You may choose to buy it directly from the New York Blood Center cuz money will go to a some sorta of Foundation or .. to improve/promote blood banking. I bought it from the Blood Center. Modern Blood Banking by Harmening, Blood banking and Tx Medicine by Sally Rudmann, Immunohematology by Eva Quinley are nice books to use in teaching blood banking for generalists. Technical Manual is a bit difficult for beginners and generalists. CK Cheng, MSc, SBB(ASCP), CQA(ASQ)
  16. I think it depends on what kinda book you want to buy cuz they are real different. Technical Manual is a all-round book from quality, genetic, donor, component preparation, blood group, transfusion practice, etc ........ however, I personally like the last edition better. Judd's Immunohematology is mainly procedures like an SOP which is good for a reference lab. Antigen Factbooks and Human Blood Group are very informative in blood grouping. So ask yourself what kinda book do you want before you buy. Hope that helps. CK Cheng, MSc, SBB(ASCP), CQA(ASQ)
  17. Wonder how many of you have read this book "Blood Tranfusion - A Conceptual Approach" by JG Kelton, NM Heddle, and MA Blajchman. A real old book with lots of cartoon drawings which help you to understand more easier. The publisher of "Essential Guide to Blood Groups" is Blackwell Publishing Ltd. Agree with Malcolm that this is a good blood bank book in beginner level, but lacks donor blood / components preparation. I am afraid books from AABB and Modern Blood Banking would be a bit difficult for beginner in high school level. CK Cheng, MSc, SBB(ASCP), CQA(ASQ) Hong Kong
  18. I think there are two ways to detect ABO incompatible. Electronic crossmatch - the fastest cuz take only seconds. Then immediate spin - take minutes. CK Cheng, MSc, SBB(ASCP), CQA(ASQ)
  19. Can not help but follow the manufacturer's procedure. Agree that result score in the final step to determine whether the reaction is positive or negative is the most important one. CK Cheng, MSc, SBB(ASCP), CQA(ASQ)
  20. IS crossmatch tests ABO compatibility, Gel crossmatch tests any unexpected antibody in patient's plasma againsting donor red cells. They test different things. CK Cheng, MSc, SBB(ASCP), CQA(ASQ)
  21. Do not understand what do you mean by extended antigen typing? Do you mean antigen type the patient or donor unit? If yes, then you should test the sample along with positive and negative controls, and document the reactions, then conclude the sample has or does not have that antigen. Hope that helps. CK Cheng, MSc, SBB(ASCP), CQA(ASQ)
  22. I wonder what do you mean by 20 mL glycerol. The bottle comes with the blood fridge should be able to hold around 200 mL liquid and we put about 200 mL 10% glycerol in it. Also, 4 inches of the probe should be immersed in the glycerol. Rashmi, when you placed the probe in the 50 mL liquid, did most of the probe immerse inside the liquid? CK Cheng, MSc, SBB(ASCP), CQA(ASQ) Hong Kong
  23. Don't understand what do you mean by 'Do you document'? What we do is we have a blood/blood component release form which required to be completed by nurse or physician. The bearer form contains (1) patient's particulars/information (2) location (3) number of units (4) what kinda blood/blood component (5) special requirement like CMV-neg, irradiation, etc.. (5) nurse/physician code and signature and (6) date. In WAIHA case, an adddition physician consent must send together with the bearer form stating that the physician in-charge knows the units is incompatible, understand the risk of transfusing incompatible blood, and closely monitor the patient during transfusion. In emergency case, physician must sign a release unmatched blood form and physician knows the risk of transfusing unmatched blood. We keep all documents/forms in blood bank and keep them for years, depends on the Requirements. Hope that helps. CK Cheng, MSc, SBB(ASCP), CQA(ASQ)
  24. Request for issue blood / blood components can be completed by nurse and presented by porter. However, when issuing unmatched blood in emergency case or incompatible blood in WAIHA case, a physician consent must be presented at the counter for collection. CK Cheng, MSc, SBB(ASCP), CQA(ASQ) Hong Kong
  25. You can find both the methods in Judd's Methods in Immunohematology and American Red Cross Immunohematology Methods. CK Cheng, MSc, SBB(ASCP), CQA(ASQ) Hong Kong
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