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Malcolm Needs

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Everything posted by Malcolm Needs

  1. Malcolm Needs
    It makes sense. I happen to completely and utterly disagree with it, but it makes sense. :frown::eek::frown:
  2. Malcolm Needs
    Yes, I'm a little worried about this too. As a matter of fact, we have just finished using a panel of cells that included an r"r cell with a weaker than normal E antigen. It was so weak that, in many cases it did not appear to react by IAT with examples of anti-E in pregnant women that other examples of r"r gave 3 to 4+ reactions by IAT (and before you ask why this cell was included - don't - we didn't produce the panel!). It does demonstrate, however, that relying on a single example of a red cell is highly dangerous.
  3. Malcolm Needs
    The bit about the Blood Bank knowing nothing about transferred units of blood seems to be a ubiquitous problem John. Sadly, anyone in the UK would recognize the scenario instantly. Now I'm going to be a real pain (nothing new there then). What if the patient was known to have an anti-HrB, came with Rhnull units, and needed an immediate transfusion? Emergency release blood would not be compatible, and it would be known not to be compatible (I am thinking of a genuine case - not being a pain for the sake of being a pain - for once!!!!!!!!!)?
  4. Malcolm Needs
    Thank you for that prompt and full explanation. I do wish we still had the "Thanks" button! :)
  5. Malcolm Needs
    We no longer have directed donors in the UK, except in exceptional circumstances, such as when only a sibling has blood antigen negative for a clinically significant antigen found in the patient, but we would never bleed the donor of a unit until we know that their red cells are compatible with the recipient. In other words, we would take a sample from the directed donor, ABO and Rh type them and then go on to perform a preliminary cross-match before the unit is taken (and then do another cross-match when the unit may actually be required, e.g. just prior to surgery).
  6. Malcolm Needs
    Well put! I have got one question though. If a desperately ill patient has to be moved from one hospital to another hospital (not in the same group), is there ever an occasion in the USA when cross-matched blood would be transported at the same time (such as in an ambulance or in a hospital helicopter/airplane), in case the patient requires transfusion in transit, or has such a rare antibody that only a few units are available (say an anti-HrB) and so would have to be shipped with the patient? (sorry, very long question!). If this does ever happen, how do the various ruling bodies cover this? :confused::confused: Over here, by the way, when such a rare event occurs, we have to have a written medical concession.
  7. Malcolm Needs
    You might try fiona.regan@nhsbt.nhs.uk. Fiona is the Consultant within NHS Blood and Transplant in England. Although she may not be absolutely the correct person to contact about this, she would most certainly know who is. If you ask her to forward your email, I am sure she would try to help. She is a lovely lady.
  8. Malcolm Needs
    No, it's not you, it's just that we call it RCI (Red Cell Immunohaematology) over here. We use DiaMed gel techniques as a first line of attack (IAT and enzyme IAT), but, if we have no joy with that, we will most certainly fall back on tube techniques, using either a polyspecific AHG or a monospecific anti-IgG reagent (or, on much rarer occasions, a monospecific anti-C3d reagent). If we still have no joy, we will send the sample to another NHSBT-Centre, who use either Ortho BioVue or a solid phase microtitre plate technique. Eventually, we will send samples to the International Blood Group Reference Laboratory. We are extremely lucky in my Laboratory, as we usually have about 60 rare "liquid" red cell samples available for use, together with in excess of 690 frozen rare red cell samples and a vast range of frozen rare antisera, mostly from SCARF, so we are a bit unusual, to say the least.
  9. Malcolm Needs
    And here is another one that may, or may not be of use. Weak D or Partial D.doc
  10. Malcolm Needs
    Well, I don't know what I did wrong the first time, but here it is. Phenotyped Red Cell Transfusions.doc
  11. Malcolm Needs
    Not quite true. We do trust the results from the International Blood Group Reference Laboratory. Whether they trust ours, on the other hand...........
  12. Malcolm Needs
    Sorry for being an idiot, but what is an IRL? If the "RL" bit stands for Reference Laboratory, I may be able to answer your question. If it doesn't, I may not be able so to do.
  13. Malcolm Needs
    Hi Cliff, I am attaching another one that may or may not be of use (and may not fall into the category). It would appear that I am not attaching another one! I'll give it another go later!!!!!!!
  14. Malcolm Needs
    Sounds to me, given that the bilirubin and LDH both rose immediately, and that the panel and DAT became positive so quickly, that the patient has had a secondary (anamnestic) response and is undergoing a "delayed" haemolytic transfusion reaction that has mimicked an acute haemolytic transfusion reaction. This also assumes that the anti-Jka is an alloantibody. On the other hand, if the anti-Jka is an auto-antibody, the subclinical auto-immune haemolytic anaemia could have been stimulated by the transfusion to become a clinical auto-immune haemolytic anaemia (with the auto-antibody possibly being a true auto-anti-Jka or an aut-anti-Jka-like antibody). :confused::confused:
  15. Malcolm Needs
    As a Reference Laboratory, we do not have the luxury of being able to draw our own samples, but we always start by performing a full ABO and D type (and usually Rh and K phenotype), DAT and antibody investigation of our own, and never believe the findings of the hospital, however good their reputation (and history of being correct) may be. However good they may be, everyone makes mistakes sometimes (and that certainly includes us). :fear:
  16. Malcolm Needs
    Hi Cliff, I'm not at all sure that this falls into the category of what you are after, but it is an essay I did for my Institute of Biomedical Science Continuing Professional Development Scheme. If you think it will be of use to anyone, please feel free to make it available. Review of the current progress in developing universal red cell products and their potential to.doc
  17. Malcolm Needs
    I don't have any myself, but it may be worth your while putting "Blood Stocks Management Scheme" into your search engine. This is the scheme run by the National Health Service Blood and Transplant (NHSBT) in England. Of course, the figures only refer to England (and a bit of North Wales), but ther may be some stuff on there that could be useful to you. :idea:
  18. Malcolm Needs
    Hello All, I'm sorry to come to this thread a little late (about three years late actually), but for those of you who are still interested in this subject, could I suggest that you try looking at a PowerPoint lecture I have posted on BBT that mat be of some interest? This sounds extremely big-headed on my part, but the lecture was actually written by my Consultant, Dr. Nay Win, of NHSBT-Tooting Centre, and not by me (so I don't feel quite so guilty advertising it). You go to References on the heading bar, then to Document Library, then User Submitted, then Educational Material, and go right to the bottom and click on the lecture. This, as I say, may be of interest; on the other hand, it may not, but it could be worth a try! :confused::confused:
  19. Malcolm Needs
    Thanks Eoin. Sounds like you did a really fantastic job. I'm glad it was you and not me!!!!!!!! :D
  20. Malcolm Needs
    As we used to say in the old days, if it isn't clear this time, transfuse them and it will pop up. That sounds so blase', but most of the time it works without obvious adverse consequences to the patient.
  21. Malcolm Needs
    Well, I liked your answer!!!!!!!! :)
  22. Malcolm Needs
    I wasn't being critical about the thread. I was just pointing out that there is obviously a problem as there were two similar threads, and yet the manufacturer says there is no problem. That, to my mind, sounds fishy.
  23. Malcolm Needs
    How did you do it Eoin? Did you have some anti-Ge available to group the donors, or did you give cross-match compatible?
  24. Malcolm Needs

    Recalls logging

    Malcolm Needs replied to RR1's topic in Quality

    Hmmmm! That's better than normal Rashmi. You usually leave out the "a bit" part of the phrase and substitute the word "very"! :wave::wave:
  25. Malcolm Needs

    Recalls logging

    Malcolm Needs replied to RR1's topic in Quality

    Touche!!!!!!!!!!!!!!!!!!!!!!!!!! :clap::clap:
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