suhu

We get a list of patients from HEM/ONC, get a pre-drug sample and send it out for genotype. The if/when screen becomes positive, we would supply phenotypically matched, but havent had this happen yet.

do you use a NEO or ECHO?

We do as Terri does, exceept for solid phase we cant "select" the cells, so a whole panel is run. Also, if the current antibody screen pattern matches the previous antibody we do not do new workups. A new workup is done a) if an unexpected incompatible xm is encountered or (b) the current antibody screen reactivity does not match the identified antibody (ex. prev. anti K, but a K neg screen cell is now positive) or c) if the previous antibody was a non-specific antibody, or clinically insignificant antibody, and we wish to interpret the current screen as cllinically insignificant . Warm auto's are considered on a case by case basis, but in general a workup is done with each new patient admission.

Thank you for your replies. I also consider Solid phase to be an enhancement, so a heterozygous rule cell is okay most of the time. Solid phase does confuse me though, as we've had patients with antibodies that react with heterzygous cells but are negative with a homozygous cell, so I'm never sure if the homo/hetero "rules" apply to solid phase.

Ok, I know I'm asking the same question multiple ways, but... For example, if no homozygous cells are available on a panel, is one negative E+e+ or K+k+ cell sufficient to rule out anti E or anti K by solid phase? Is the rule different for different antigens? Essentially, do you consider solid phase a more sensitive test, therefore one negative heterozygous cell is sufficient to use for rule out? If a solid phase panel demonstrates a clear-cut antibody pattern (no extraneous, unexplained reactions), can a heterygous antigen expression be used for rule outs?

When a new component label is applied to a product our blood bank modifies, for example an irradiated red cell or an aliquot preparation, what FDA registration number and/or US license number is required to be on the product label? The new component label we apply has our FDA registration number, but is it required to redact the supplier's FDA registration number and/or license number?

thanks for your replies. the problem is the graph readings. the lines are quite close together and go by 1 degree increments so the chart reading is subjective. plus its in an awkward position near the floor requiring techs to bend way over or get down on the floor to read it....other charts are near the top of the freezers and are difficult for the height challenged techs to see... the digital readout records to the tenth of a degree. so we have people recording temps as, ie. chart -25.5 digital 27.9...... the freezer is well within proper temp range, but the temp difference is out...not sure how to remedy this...

We have a both a teperature chart and digttal readout on our refrigerators, platelet storage and freezers. Both readings are recorded daily and the SOPs state that not only must they be within range, but the difference between the 2 must be less than or equal to 2. This is no problem for the fridges and platelet storage but the chart and digital readouts for the freezers sometimes differ by slightly more than 2. With the wide temperature range (-18 t0 -30), I'd like to change the difference to 5 for just the freezers. Would this violate any regulations? I cant find anything...we are inspected by CAP, CAP-ISO, and FDA. thanks

We have a both a teperature chart and digttal readout on our refrigerators, platelet storage and freezers. Both readings are recorded daily and the SOPs state that not only must they be within range, but the difference between the 2 must be less than or equal to 2. This is no problem for the fridges and platelet storage but the chart and digital readouts for the freezers sometimes differ by slightly more than 2. With the wide temperature range (-18 t0 -30), I'd like to change the difference to 5 for just the freezers. Would this violate any regulations? I cant find anything...we are inspected by CAP, CAP-ISO, and FDA. thanks

We use one form "Emergency Release Form", with one statement when any products are released before testing is completed. We add a bright Avery sticker that says "Dr. sign and return to Station 118" . We send the form along with the emergency products, docs then sign and return. We rarely have an unreturned form, although this did have a learning curve, as things were not so "quality controlled/managed" in the old days. The signature statement on the form reads "due to the gravity of the patient's condition, I am requesting the release of blood products prior to the completion of compatibilty testing". Techs do notify the patient physician for patient's with known antibodies, or positive/unresolved crossmatches/panel. We keep an inventory of unconfirmed pre-screened antigen typed units- so for the antibody patients we choose those units if we can. If there is time for full crossmatching, we issue the serologically compatible units, but if the antibody id is pending, those crossmatched units are released under Emergency Release process. We are required to notify both the patient physician and the blood bank medical director if subsequent testing finds that an incompatible unit was issued.

Helmer does agitate between washes. I thought that was standard for wash cycles.

For decades we did as the original post. Recently, we changed our SOP and now the techs need to get approval from the Transfusion Medicine physician prior to the release of additonal units for any transfusion reaction. We added a comment to the Transfusion Reaction computer entry to document this. The issue procedure was changed to include a computer check for a recent HTRXN reaction test and if one, they are to look at the results to see how the comment was answered (ie, TRM notified-OK to transfuse). If the comment is pending, they are to resolve before issuing additional units. Surprisingly, this has been working fine

Thanks for your ideas David. To clarify what I wrote, we do have automated cell washers, but with these samples the buttons get super stuck to the tubes and the check cells never work. So techs are instructed to repeat testing and wash by hand so the buttons can be re-suspend between washes and give them an extra wash. Occasionally though, even this doesnt work.

We occassionally have problems with PeG testing where the check cells fail. These are the high protein plasma's that turn super cloudy when PeG is added. Handwashing and "flicking" the cells off the bottom of the tube inbetween washes helps some, but some are really stubborn and just won't check. Does anyone else see this and what do you do? thanks.

Problem is when we thaw plasma for apheresis. The waterbath can be loaded with 8 plasma's over 300cc and they dont completely thaw under 30 mins. Techs are wanting to just set the timer to 45 mins. because they dont have time to keep checking them. I'm okay with this if they are still cold after 45 mins. but what if a couple smaller volume units are mixed in that will thaw sooner? Is this extra time acceptable for those units?