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JEMarti

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About JEMarti

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    Junior Member
  • Birthday 07/23/1965

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  • Gender
    Male
  • Location
    Chicago, IL
  • Occupation
    Associate Director of Marketing for a major blood bank diagnostics company.

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  1. We had a presentation 3 weeks ago from the manufacturer at a local BB conference. They indicated that the positive Ab Screen can show up within the first day and positive DAT can persist 6 months or more post treatment. They are recommending phenotyping the patients prior to starting DARA therapy and using DTT treated cells for screening and transfusing K negative units to patients who are K neg.
  2. I think the concern here is not regarding gel testing but may be referring to the fact that (as far as I know) all automated analyzers sample their RBCs from the bottom of the specimen tube (for the simple reason that the instrument does not detect where the cell/plasma interface is). Therefore, if the population of RBCs at the bottom of the tube might be skewed toward transfused cells such testing may be erroneous. However, since we do backtypes, unless we have totally diluted out the patient's antibodies we will always be able to catch a discrepancy and resolve it manually.
  3. In Europe Ortho uses glass bead technology. In the US they use gel.
  4. Grifols was the OEM manufacturer for the ProVue and manufactured all of the ProVue instruments for Ortho. Ortho is still allowed to service their ProVue instruments and Grifols has no say as to Ortho's policies regarding the servicing of Instruments sold under the Ortho name. Ortho can continue servicing them until they exhaust their spare parts inventory or until they choose to stop servicing them. Grifols provided spare parts to Ortho until the ending of their contract. The patent situation was that Ortho had license to the patent for gel testing and had blocked both Grifols and Bio-Rad
  5. The reason that you irradiate HLA matched platelets is because the risk of TAGVHD is greater when you have the likelihood of a close HLA match between donor and recipient. Such a match is unlikely with an RBC from the shelf. As for cytokines, my thinking would be that refrigeration would lead to a greater amount of them being released since WBC's do not fare well in the fridge.
  6. I just arrived here in the Bay Area late last night (my office is here despite my living outside of Chicago). The earthquake was centered in Napa so most of the damage was up there and not really in the Bay Area directly. What I can say is that the good news is that this area is extremely well prepared to deal with this. Building codes mean that most structures are able to withstand the quake and while there are a lot of older buildings that sustain damage and quite a few will have to come down, very few people were seriously injured. When you get to the San Francisco/Oakland area things a
  7. You say that the reference lab screened 9 donors to find 1 compatible. Are you sure that you are talking about HLA antibodies? HLA matched products are not screened on the shelf. You identify a donor and collect them specifically for the recipient. You may luck out and have a product from a matching donor available but you don't go screening units. What you describe sounds like a platelet crossmatch because your patient has platelet antibodies. As for HLA: TAGVHD is caused by having transfused lymphocytes that are a very close HLA match to the recipient mount an immune response against
  8. As I am no longer working in the lab (having left to go into industry) I will answer... If memory serves, in the lab I left 3 years ago we were paying $245 for a unit of LRBC's from our local supplier. I think that the key factor is where you are located rather than the size of your institution. If there is competition for your hospital's business then your prices will be lower. If there is not then you are pretty much stuck even if you are a large university hospital. With ever increasing consolidation in the industry the likelihood of your being able to shop around for a supplier is s
  9. I think the problem you are going to run into is that there simply isn't any documentation or literature surrounding this issue. You might try to point out the fact that there isn't anything written on this issue and that you cannot find any other institution anywhere that does this. You could compare that to the fact that apheresis manufacturers all specify the resting period after collection for their instruments but are silent on resting after any kind of shipment. (this latter is significant since blood centers have satellite centers collecting apheresis platelets and they will not adher
  10. The issue is that you face two separate problems. 1) Sufficiently describing the effects of repeated freeze/thaw cycles on the product and demonstrating that it maintains the clinical utility that is expected. This would lead to defining an expiration based on cumulative thawed time and number of freeze/thaw cycles. 2) you need to identify a tracking mechanism that can ensure that the defined limit on cumulative thawed time/number of freeze/thaw cycles is not exceeded. Which brings us to the 3rd and biggest obstacle: Who has time for all that and does the investment of resources deliver a pa
  11. Gel cards might seem expensive but they are cheap compared to the antisera. Considering that a drop from a dropper is ~100ul you can cut your antisera costs by 75% per test by using 25ul in a gel card. WIth some antisera running around $1000 per vial the antisera cost is potentially the biggest component of the test. Also, in a past life I did a cost study on antigen typing and in interviewing bench techs discovered (surprise) that techs often rely upon their training for how they do Ag typing and not the package insert(or their SOP). So while the package insert says to use 1 drop and ho
  12. The reason the method is not recommended is because the manufacturer does not have sufficient data to support the use and what they are telling you is essentially an off label use for their product. So legally they cannot make an official recommendation but they can tell you what is technically possible and that you need to validate it or QC it yourself. Even then I would be shocked to see them put this into writing. Undoubtedly, this works fine but manufacturers are constrained by regulations as to what they can recommend as the use for their products.
  13. Blood pressure increases with the infusion of fluid. That is not necessarily an improvement especially in patients with CHF. Infusing cells can also increase blood viscosity which is not always beneficial either. But no, one does not transfuse in order to rescussitate a patient's BP.
  14. Most? I have never seen any article claiming that blood transfusion was linked to autoimmune diseases. And if transfused stem cells were causing those symptoms by definition it is not an "auto" immune disease. This article contains some truth but what is there is put in the most alarmist and misleading way. It seems calculated to gain himself notoriety at the expense of others inluding the medical community and patients as well. Sadly, this is not the first newspaper article slamming the blood industry with falsehoods and misrepresentations, and it is unlikely to be the last.
  15. Absolutely! I recall many years ago the night shift generalist getting an plasma order for a baby in the NICU. He thought, "babies in the NICU get O Neg, CMV Neg." Wouldn't you know that we happened to have a unit of FFP in the freezer that was O neg, labeled as CMV neg. The next day the baby had a 4+ DAT. People who are not blood bankers at heart sometimes have a real problem with plasma vs RBC ABO compatibility Depending on who you see in your ER you may choose to put a caveat on the plt >20,000 requirement to not get called for patients with active bleeding.
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