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Malcolm Needs

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Malcolm Needs last won the day on February 14

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About Malcolm Needs

  • Rank
    Seasoned poster
  • Birthday 12/14/1954

Profile Information

  • Gender
    Male
  • 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. Malcolm Needs
    Welcome akhitum.
  2. Malcolm Needs
    Welcome Blackl.
  3.    Malcolm Needs reacted to a post in a topic: Blood Group Discrepancy
  4.    exlimey reacted to a post in a topic: Patients with blood type A Bel, what to transfuse?
  5.    Emelie reacted to a post in a topic: Patients with blood type A Bel, what to transfuse?
  6. Malcolm Needs
    You bet! There is NOBODY better! ANYWHERE!
  7.    Malcolm Needs reacted to a post in a topic: Patients with blood type A Bel, what to transfuse?
  8. Malcolm Needs
    I don't want to interfere, but have you thought about sending a sample to Martin Olsson's laboratory in Lund? He is the world authority on the ABO gene.
  9.    Malcolm Needs reacted to a post in a topic: Patients with blood type A Bel, what to transfuse?
  10.    Emelie reacted to a post in a topic: Patients with blood type A Bel, what to transfuse?
  11.    David Saikin reacted to a post in a topic: Reverse Typing using IgG testing with patient with a strong cold
  12.    David Saikin reacted to a post in a topic: Patients with blood type A Bel, what to transfuse?
  13. Malcolm Needs
    Welcome miniviolet1.
  14.    Malcolm Needs reacted to a post in a topic: Blood Group Discrepancy
  15.    Ensis01 reacted to a post in a topic: Patients with blood type A Bel, what to transfuse?
  16. Malcolm Needs
    Certainly when the A antigen on the red cell is sufficiently strong to give the reaction you posted earlier.
  17.    Malcolm Needs reacted to a post in a topic: Blood Group Discrepancy
  18. Malcolm Needs
    Did you really mean "an Anti-A", and not an Anti-A1? Surely, if the A antigen is expressed on the red cells, however weakly, the patient cannot produce an anti-A, unless it is an auto-antibody?
  19. Malcolm Needs
    Putting aside the A antigen for the moment, which is probably "normal" in the case of your patient, it is not the B antigen that is abnormal in the case of a Bel person, but the 3-alpha-galactosyltransferase enzyme (the direct gene product of the ABO gene) is less active than normal, due to a mutation in the gene. The actual carbohydrate residue that is on the red cell is "normal" - just less of it. In addition, there is competition between the "A-transferase" and the "B-transferase" for the H-backbone. In the case of your patient, the "A-transferase" will "win" this competition and this will accentuate the weakening of the B antigen even further - but the actual structure of the B antigen will be the same as the normal B antigen - just fewer in number. This explains why there is no anti-B present in your patient's circulation. This (rather long-winded) explanation should serve to prevent you worrying about giving your patient group AB blood should they require a transfusion.
  20.    Ensis01 reacted to a post in a topic: Blood Group Discrepancy
  21.    Malcolm Needs reacted to a post in a topic: Blood Group Discrepancy
  22.    srichar3 reacted to a post in a topic: Blood Group Discrepancy
  23. Malcolm Needs
    Looks like an AsubgroupB to me, but, these days, with monoclonal antibodies, which type of A subgroup can only be accurately sorted by molecular techniques. The reverse group needs more investigation. It could be anti-A1, it could be another "cold" antibody specificity (such as anti-M or anti-P1), or it could be a combination of the two. If there is no reaction at 30oC and above, it doesn't really matter, but, to be on the safe side, if blood is required, I would give group B packed red cells, or group B red cells resuspended in AB plasma.
  24. Malcolm Needs
    Welcome Jude Adjal.
  25. Malcolm Needs
    Welcome KX36.
  26.    Malcolm Needs reacted to a post in a topic: Reverse Typing using IgG testing with patient with a strong cold
  27. Malcolm Needs
    Welcome ncase15.
  28. Malcolm Needs
    Welcome LauraM.
  29. Malcolm Needs
    Welcome Tessie2020.
  30.    Malcolm Needs reacted to a post in a topic: Reverse Typing using IgG testing with patient with a strong cold
  31.    yan xia reacted to a post in a topic: Reverse Typing using IgG testing with patient with a strong cold
  32.    Likewine99 reacted to a post in a topic: Probably a silly question...
  33. Malcolm Needs
    I don't know for certain, but I bet they did a bit more than that. Almost all "cold" auto-antibodies are IgM, it is true, BUT, because these antibodies almost always have a very wide thermal amplitude, they would cause "spontaneous agglutination" in tests incubated at 37oC too. What they probably did was to either adsorb out the "cold" auto-antibody with something like rabbit erythrocyte stroma, or denaturation of the IgM molecules by a reducing agent, such as dithiothreitol (DTT), and only then performing tests using a monospecific anti-IgG reagent. I am quite happy to be corrected.
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