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Joanne P. Scannell

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Everything posted by Joanne P. Scannell

  1. Ruling out with only heterozygous cells (with few exceptions, e.g. Anti-K) is risky business. I don't allow my staff to do that and I don't recommend it. There are plenty of examples of antibodies that react with homozygous cells only (due to sensitivity of the test and concentration of the antibody) ... so you will get a negative result with heterozygous cells whether you run 1, 3 or 999 of them.Sure, if you miss such an antibody, it is weak and will likely not cause a noticeable 'reaction' ... you'll likely see it better next time around. Oooor maybe you won't, some patients never pass tha
  2. You cannot extend an original outdate whether you are thawing, pooling, irradiating or anything else. It is always 'whichever comes first', the original outdate or the 'new' outdate.
  3. We are using the ELUclear Kit (Hemo bioscience) and the 0.8% reagent red cells (Ortho/J&J, whoever they are now) and have no problems ... and we do a lot of eluate preps/testing.
  4. I'm assuming you are talking about the little 12x75 or 10x75mm tubes used for 'Tube Testing'. Ditto ... polystyrene, not polypropylene. We tested several tubes years ago when we made the switch from glass to plastic. The difference has to do with the way the tubes are made (molded vs extruded) and the little micro pits and valleys caused by these differences ... pits and valleys will 'catchup' the button, etc. If you are in the US, I can pass on to you the name/# of the vendor we use for these tubes ... this company is very knowledgeable about the differences and they don't gouge their
  5. I agree with Mabel ... you did 'the right thing'. What did he/she really expect a reference lab to do with this anyway? And, as she reminded, we do 'rule out' clinically significant antibodies with one homozygous (with exceptions, such as Anti-K which doesn't show much dosage anyway) every time we have a negative Antibody Screen.
  6. True ... agreed. My point was that we shouldn't 'jump' to the conclusion that a baby is an A3 just because mixed field reactivity is present without considering the testing platform/sample and the possibility of maternal-fetal bleed/contamination.
  7. Just a thought: How are you testing these babies? If you are using cord samples or if there were some maternal-fetal bleeding (how was the birth?), the child you are tagging as an A3 because of the 'mixed field' reactions may actually be a normal Group A ... the mixed reaction due to maternal red cells in the cord sample/baby. If you are using MTS, this is obvious and I know there is some literature out there illustrating this warning because it is a change from what we were taught 'way back when', i.e. that cord samples/babies may have weaker reactions with Anti-A and/or Anti-B ... but tha
  8. We have a similar situation with our 'Cancer Center'. The patients keep the bands on ... no more than a month because the policy is for them to re-register monthly. I don't know why that is. New band = new Pretransfusion specimen = new ABO/Rh typing.
  9. This is EXACTLY why we require a BB Band ... attached at the time of draw and must be intact. You never really who who's in the bed ... the BB Band links the patient to the specimen. Once the band is removed, no more link = no more transfusions until a new specimen is obtained. It's a pretty sad world where we have to have people cheat the system in order to get healthcare.
  10. We BB Band all pretransfusion specimens/patients ... as long as they are wearing that BB Band, they can recieve plasma products (plasma, platelets, cryo). W nb. We have patients who move between our facilities that we service so to say 'this admission' is not applicable.
  11. Am I 'hearing' this right? So when manufacturers state that testing has to be performed within x days (and they always say that donor units are ok until outdates), there is NO scientific evidence for these statements?
  12. We don't have a refrigerator in the OR. Our promise is that blood will be ready in 5 minutes. We do what we need to do to fulfill that promise, e.g. crossmatch ahead if the patient has clinically significant antibodies. (In those cases, we automatically set up 2 and call the surgeon ahead of time to see if more is necessary.) Basically, they call for blood and then come get it ... they have no idea what we are doing in the BB.
  13. Sunquest with Invision. Ordering via various vehicles ... e.g. CPOM. We are in the process of changing Invision to Epic.
  14. Yes. 00:01 Jan 1 will expire on 23:59 Jan 4. AABB
  15. AABB changed 72 hours to 3 days many years ago. Date of draw being Day 0. This way, the specimen expires at midnight ... just like everything else.
  16. I agree ... instinct/training/experience has it's effects. It comes down to 'When in doubt, don't rule it out'. We have a whole set of LIS codes for 'Possible Anti- ___' because of this. And yes, they function to restrict allocation of antigen-pos/antigen-untested RBCs. Aside from that, the basic answer to the original question of this thread is 'Do not rule out using heterozygous cells.'
  17. What happened to the 'good old days' when we used to call the floor in the middle of the night to tell them that unless this was a life-threatening situation, the transfusion will occur during the day? Tired patient? Go to bed, go to sleep. Poor Malcom! How did your patient pan out? More antibodies (a responder, for sure!). More support for transfusing 'phenotype-identical' to these frequent flyers? (Was this patient phenotyped?)
  18. We do not use heterozygous cells (with few exceptions, e.g. Anti-K, -Cw, -Lua) to rule out. I have several examples of clinicaly significant antibodies that react ONLY with homozygous cells in our files. I got validation of this concept at an AABB session in Baltimore, MD (was that 2005?). A well known reference lab mid-USA was presenting case studies and a big 'take home' was 'Do NOT rule out with 'heterozygous' cells!' In fact, be wary of ruling out with 'all' 'homozygous' cells because what may appear 'homozyous' on the panel sheet may actually be 'heterozygous' with an allele that is no
  19. Lots of ideas presented here. Basically there are these possibilities and they all need to be considered/investigated: 1. Specimen from prenatal/previous testing was mislabeled, e.g. someone else's blood. 2. Tech made an error somewhere along the testing path or recording during the previous testing. 3. Tech made an error somewhere along the testing path or recording during this testing. 4. Sample 'today' is the 'wrong' patient ... misdraw, misidentification or maybe another patient who is not who she says she is (e.g. using someone else's insurance card, it happens a lot in my area). 5. You a
  20. I see. We eliminated the 'crossmatch x units' orders ... they don't exist in our system. No purpose for them. The only orders the MDs have to choose from are 'Transfuse RBCs', 'Transfuse Plasma', etc. The MDs are oriented to this ... order only what you want to transfuse. I must add that when we are performing pretransfusion testing for pre-ops, if the patient has atypical antibodies, we DO crossmatch 2 units and we call the surgeon to see if he/she thinks that more will be needed for the particular surgery so we can be ready with them ahead of time. So, if you can change your order descrip
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