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Malcolm Needs

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Malcolm Needs last won the day on June 25

Malcolm Needs had the most liked content!

About Malcolm Needs

  • Rank
    Seasoned poster
  • Birthday 12/14/1954

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  • Gender
  • Interests
    Rugby Union, Cricket, cooking, wine, port, reading, crosswords, lecturing, more wine and more port!
  • Biography
    Pretty boring really, but not that pretty!
  • Location
    Croydon, Surrey, England
  • Occupation
    I have taken a brand new role in the NHSBT and am now involved very much more on the education and training side of red cell immunohaematology. My title is still Reference Service Manager, but with Training after it (Reference Service Manager - Training). I am very excited about this change, as I have a passion for training and education.
    Reference Service Manager with the NHSBT.
    Chartered Scientist.
    Member of the British Blood Transfusion Society, having twice served on their National Council.
    Fellow of the Institute of Biomedical Science. Member of their Special Advisory Panel for Transfusion Science and Chief Examiner for Transfusion Science for the Institute.
    Author of the chapter "Human erythrocyte antigens or blood groups" in Fundamentals of Biomedical Science, Transfusion and Transplantation Science, edited by Robin Knight, for the IBMS. 1st edition, Oxford University Press 2013 (ISBN 978-0-19-953328-2, pages 19-44.
    Just been appointed to the BCSH Blood Transfusion Task Force (writing Guidelines).
    Member of ISBT and AABB.
    I am now retired from the Blood Service, but still do the other things!
    Got bored with being retired, and so am doing locum work in Blood Transfusion at St. Richard's Hospital in Chichester, West Sussex (and thoroughly enjoying myself!).

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  1. It MUST be remembered that not all antibodies react by all techniques, but, equally,it MUST be remembered that not all antibodies are clinically significant. I remember way back in the 1980's, when I was working at a hospital in Croydon, Surrey, UK, we had an anti-S that we could only detect by tube technique. We sent this around to a whole bunch of other hospitals, who also used a mixture of techniques. Not one of them could detect the antibody by either microplate techniques or column agglutination techniques, both thought to be more sensitive than tube techniques, but all of those who also used tube techniques were able to detect the anti-S. I also remember having an anti-E that did not react with enzyme-treated red cells, but only reacted by IAT with untreated red cells. This was confirmed by the International Blood Group Reference Laboratory. Antibodies do not read books, particularly text books! Antibodies are only clinically significant if they react strictly at 37oC, and even then, not all are clinically significant. Think about the antibodies against antigens in either the Knops or Chido/Rodgers Blood Group Systems.
  2. In every place I have worked, the KB has been performed in Blood Bank. In every place I have worked, I have argued that the KB should be performed in Haematology, on the grounds that the staff in Haematology are far more experienced at 1) looking down a microscope (or, at least, they should be, as microscopes should not be allowed anywhere near a Blood Bank (see Issitt), and 2) looking down a microscope at minimal numbers, such as basophils and reticulocytes, whereas true positive KB's are very rare. I was consistently ignored!!!!!!!!!!!
  3. Most certainly, this is what Joyce Poole, the Head of Red Cell Serology at the International Blood Group Reference Laboratory told me, and there is NO WAY I would argue with Joyce!!!!!!!!!!!
  4. I'm glad it's not just me David!!!!!!!!!!!!!
  5. From empirical, but unpublished evidence when we started to use them in the early 1990's (before our units were universally leukodepleted, we found this to be true.
  6. Ah cswickard, I was talking more about the C, c, E and e antigens, rather than the D antigen, which is much more immunogenic. Sorry, I should have made that distinction.
  7. Well, the high potassium is undoubtedly a factor, in particular as it is a cardiac case. All units in the UK are leukodepleted, but I wouldn't have thought that "unleukodepleted" blood should be of too much concern in this case. The difference in the Rh type would be of no concern to me whatsoever. The baby's immune system would be immature, and so it is highly unlikely that the "foreign" Rh antigens would cause immunisation. Indeed, exposure to these "foreign" Rh antigens may be advantageous in a way, as there is the possibility, as this age, that these may lead to "accomodation", meaning that the baby may never produce antibodies against these antigens, but this has not been proved, as far as I know.
  8. This is most certainly a decision for a clinician, although I do have some ideas myself.
  9. Because, believe it or not, there are some dinosaurs out there who still demand them, because they don't trust monoclonal antibodies, and they are senior enough (God knows how) that they cannot be over-ruled. If sufficient people still want them, people will still produce them and sell them to the dinosaurs, at higher and higher prices.
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