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Malcolm Needs

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Everything posted by Malcolm Needs

  1. Maybe it is a mixed cold and warm AIHA - rare, but they exist (I co-wrote a paper on a case), in which case the "cold" could be an auto-anti-H, or even just the normal auto-anti-H commonly found in group A plasma. That would explain the weak reactions with group A red cells.
  2. I think your physician's diagnosis is probably correct, as it very much looks like a "warm" auto-antibody, but you will need to ensure that there are no underlying clinically significant atypical alloantibodies.
  3. It sounds remarkably like one of your screening cells is expressing a low prevalence antigen that is not expressed on your panel cells. Antibodies directed against low prevalence antigens are actually quite common, but they are rarely detected because red cells expressing the cognate antigen are so rare. I wouldn't expend too much time or energy trying to sort out the exact specificity. In all cases of such an antibody, as long as you cross-match by the same method as you used in detecting the presence of the antibody in the first place, it would be quite safe to give cross-match compatible blood. The other thing is that the screening cell may be expressing an HLA antigen. You could treat the cell with chloroquine, and that will get rid of the HLA antigen.
  4. I couldn't agree more with you YorkshireExile. At a stretch, and I mean, at a stretch, it MAY be relevant to such tests as quantification and titrations, where you are giving a result involving a measured number, ascertained with red cells that may express different numbers of antigens, which may themselves involve protein or carbohydrate substitutions, but that is all. How on Earth your inspector thought that this was remotely relevant to blood grouping, with all the positive and negative controls used to ensure the antisera are working properly, and the temperature mapping of everything these days, like you, I cannot see the point. Either he or she was trying to justify their position as an inspector, and/or was going well over the top. I would be amongst the first to say, very loudly, that Quality in the world of Blood Transfusion was pretty low at one point, but now, there are times when Quality issues actually interfere with the laboratory doing its job, for no good reason, and this seems to me to be one. END OF RANT.
  5. Yes. All changes have to be validated.
  6. 1:1024 is NOT a titre; it is a dilution.
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