jmphil4

I just answered this question. My Score PASS

I just answered this question. My Score PASS

I just answered this question. My Score PASS

I just answered this question. My Score PASS

I wouldn't suggest that with all non-specific reactions. Just if you get an impression that there might be a kidd, it's better to error on the side of caution. I've certainly called my fair share of unknown/non-specific reactions. I've seen several antibodies who don't react even with all of the homozygous expressions. Honestly, sometimes its not much more than your blood bank "spidey-sense" that leads you to the antibody ID, when you would have been completely correct (per SOPs) to call something unknown.

My game plan with the kidds is to honor what antibody I think I see (assuming it agrees with their phenotype). Because titers with kidds are notorious for falling quickly, and their transfusion reactions can be particularly unpleasant, I always think its better to be safe than sorry.

Our plan for the patients is to do a preliminary type and antibody screen, along with a full phenotype, before they begin treatment. Once they begin the medication, we will perform elutions on the patients. This should allow us to identify any newly formed antibodies that wouldn't be detected with the DTT treated cells.

I know of no regulation preventing this, but I've always heard directed donations may not be as safe as other volunteer donors due to pressure to donate...I'd think this would be a similar situation, people will feel pressured to not tell the truth on the donor questionaire.

Thanks!! I looked at the article and am not sure it applies. We treat our antibodies of undetermined specificity as clinically significant and will always provide AHG crosmatched blood even if the antibody is not showing (for our sickles we would honor their full phenotype). But in the case of an identified clinically insignificant (M, Lea, etc) we would not honor the full phenotype and I'm curious if there is any clinical evidence that confirms that. Since the point of honoring the phenotype of a patient with a clinically significant antibody is that they're a responder and now that they've formed one you don't want them to form any more, why would the formation of any antibody (significant or not) not indicate the patient is a responder. My thought is that the immune system doesn't know we label certain antibodies as clinically significant, so what's the difference? Thanks!

I know we can't know how each individual will respond to each unit, but is there any research out there that says patient with clinically insignificant antibodies don't usually form a clinically significant antibody?

Our current policy for transfusing our sickle patients is to honor their Rh and Kell phenotypes until they form a clinically significant antibody. At that point we will honor their full phenotype as they are considered a responder. But if they form a clinically insignificant antibody, we continue to honor only the Rh and Kell phenotype. Are only patients who form clinically significant antibodies considered responders? This has become a topic of conversation at our hospital and no one is sure what the correct answer is. If any one has any info that would shed some light is would be greatly appreciated!! Thanks!! (Also, if you have any articles siting this it would be even better!!)

1-10 C here too. At 1-6 C I'm not sure many units would be acceptable for reissue.

Ortho put out a new 'pocket blood banker app'. It's got some different blood groups and runs you through the patients probable Rh genotype based on phenotype. It's definately not the technical manual (lol ), but it's a neat little app that's free.

OK, so the program is self-paced, but you only have 12 weeks to complete it. It's scheduled-you have to apply and there are 3 opportunities per year to take it. I'm still not 100% sure I'll take it--if I do I'll let you guys know!!

I checked them out and asked for more info about their SBB review and their Masters in Immunohematology program. Apparently the Masters program has been discontinued (for civilians). I haven't heard back about the SBB review, though the site list the cost as $1000. They mention they plan to start Masters in CLS program ~spring 2014. Hope this helps!