Malcolm Needs

Oh yes shily, you are right. It was just that skyanto wanted a method.

Far, far too late!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! :rolleyes::rolleyes:

One way is to treat the plasma/serum/eluate with 0.01M dithiothreitol (DTT) at 37oC for about half-an-hour. This has the effect of disrupting the J-chain holding together the IgM molecule, by reducing some of the sulphydryl bonds. You then perform a titration, using the IAT at 37oC and a monospecific anti-IgG reagent. Don't forget to use something like an auto-anti-I (which is going to be IgM) as a control. Hope this helps. :):):)

Yes, we have them over here in the UK too. There are two types. The first is the Technical Advisory Group for Transfusion Science, run by the Hospital Chief Biomedical Scientists, but with input from the NHSBT (Hospital Liaison, a Consultant Pathologist to give clinical input and the Reference Service Manager). The second is a User Group, run by the NHSBT. These are some of the most useful meetings I attend. In addition, the various Regional Transfusion Committees run Education Days each year. This is all in addition to the vaarious education days run by the Special Interest Groups of the British Blood Transfusion Society, and various meetings held by the Institute of Biomedical Science, The Royal College of Pathologists and the Severe Hazards of Transfusion Scheme (SHOT), to name but a few. :D:D:D:D

I agree.

Only she knows!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! I daren't ask!!!!!!!!!!! :eek::eek::redface::redface:

I also agree, but the lady about whom I wrote swears that she has had no opportunity to have had a miscarriage. Mind you, having said that, she works at the world famous Kew Botanical Gardens, and she thinks that she "caught" the anti-D from an exotic plant! You can make of that what you want! :confused::):confused:

I didn't feel insulted either; maybe I should have done!!!!!!!!!!! Having said that, if you had been for real Mabel, everyone's opinion is as valid as everyone else's, as far as I'm concerned, and I'm not easily insulted anyway. I have a "hide like a rhinosaurus" (and many say the looks)! :D:D:D:D:D

Hi Candace, Yes, anti-D can be detected for a quite remarkable length of time after the last apparent stimulation. Just to check my facts, I went back to Mollison's Blood Transfusion in Clinical Medicine, Ed Harvey G. Klein and David J Anstee, 11th edition, 2005, Blackwell Publishing. In Chapter 3 "Immunology or Red Cells", page 70, it is stated, "...Some IgG antibodies (e.g. anti-Rh D) decline far more slowly and may be readily detectable 30 years after the last stimulus." Whilst in Chapter 5 "The Rh Blood Group System (and LW)", page 191, it is stated, "Anti-D can sometimes bedetected in the serum a very long time after the last known stimulus; for example, it has been found in a woman 38 years after her last pregnancy." Whilst neither of these cases can compete with your 47 years, it seems likely that such an antibody (particularly if it were very strong when first stimulated) could be detectable for such a length of time. Incidentally, we have been following an anti-D in a lady in her mid-twenties for about 5 years now, with a quantitation level of 35IU/mL (we start worrying about anti-D causing HDNF with a level above 4IU/mL) and she states quite categorically that she has never had a transfusion and has never been pregnant. I suspect that this anti-D, whatever its cause, will be around for many years to come. :eek::eek:

Congratulations Lara! :D:D:D:D:D:D:D:D:D

Well, rather like a child with selective hearing, I think I must suffer with selective dyslexia!!!!!!!!!! :rolleyes::rolleyes:

Agreed. That was sort of what I was getting at in my earlier post. :redface:

I agree with this (although I must admit that I misread the middle consonant for vowel the first time I read it)! :D:D

Hmmm. Maybe she's after a job at my place then. She would fit in well with the rest of my staff, all of whom, from the most junior to the most senior, spend every spare moment taking the micky out of me; and they're a superb bunch - I wouldn't have it any other way! :D:D:D:D

I know from where you are coming heathervaught, but that statement is not absolutely true (or, at least, it is not true for the UK Guidelines). A patient is still eligible for an electronic issue of blood or an "immediate spin" cross-match if the antibody detected is NOT clinically significant. For example, if wide thermal amplitude "cold" auto-antibody is present or, come to that a warm auto-antibody is present, but extensive serological work shows that no clinically significant atypical alloantibodies are present (or as much as it is possible to say), then the patient would still be eligible for, at the very least, an IS cross-match, on the grounds that a serological AHG cross-match would almost certainly be incompatible anyway. I know I am being pedantic here, for which I apologise, but needs must (if you will forgive the (intended) pun! :redface::redface:

I was in "Word" at the time (which was why I had to do it as an attachment). When in "Word", if you go to "insert" on the tool bar, and look at the drop down menu, you will come to something labelled as "symbol...". If you press on that, you are given a whole load of different alphabets, symbols (such as smily faces, etc), and you just press on one of those and, "Bob's your uncle"! :):)

A diphthong is when two letters are pronounced as one (for want of a better way of putting it), so that US English will spell the word as "fetus", whilst UK English (or, at least, old fashioned fuddy-duddies like me) will spell the word as "foetus" - the "oe" bit being the diphthong. Originally, the o and e ran into each other in the spelling, so that the left half of the "o" showed, but the right half of it sort of "slid" under the left half of the "e". You can see what I mean much easier in the attachment. :D:D:D Diphthong.doc

IMO, Yes.

Hi Mabel, Yes, transfused red cells do get sequestered in the spleen, or, should I say, at least small volume red cell transfusions get sequestered to the spleen for a time (unless they are destroyed by intravascular haemolysis). This was shown with radio-isotope-labelled red cells, in the days when they used to inject small volumes of incompatible red cells to see how long they survived in the circulation (and thus boosted the antibody titre!). The red cells disappeared into the spleen for a while before coming back out into the circulation. Obviously, this does not happen in cases of large volume transfusions. I have never read that such research was done on newly delivered mums, get I have a very strong suspicion that the situation was extrapolated from these isotope experiments. Whether or not it actually holds any water, I know not. :confused::):confused:

Good idea, but it'll be a HUGE thread. Better ask Cliff how big the site can go!!!!!!!!!!!!!!! :rolleyes::rolleyes:

It's UK English (with a bit of Greek and Latin derivation thrown in)! If it's any consolation, I am often accussed of thinking in a weird way too!!!!!!! :D:D:D

NHSBT has been inspected for many years by the MHRA - and they still seem to delight in making it as difficult as they can.

We had a case of a pregnant lady the other day that I was totally convinced was a partial DIII with anti-D in her plasma. I was wrong. Although it reacted with all of our anti-D sera (as would a partial DIII), when molecular studies were performed, it turned out to be a DOL with anti-D. :redface:

Ah, but nowadays, you have to be able to prove why you haven't killed anyone, including the bits that are totally and utterly irrelevant. Yes, without doubt, we did need to improve our Quality Systems, but now the world has gone completely "Quality Mad", and it has become thoroughly intrusive, to such an extent that it is preventing people doing things that actually help patients (which is our raison d'etre). :mad::mad::mad::mad::mad: