Jump to content

Malcolm Needs

Supporting Members
  • Posts

    8,535
  • Joined

  • Last visited

  • Days Won

    1,000
  • Country

    United Kingdom

Reputation Activity

  1. Like
    Malcolm Needs got a reaction from Bet'naSBB in Cold auto antibodies   
    Could NOT agree more Neil.
  2. Like
    Malcolm Needs got a reaction from John C. Staley in Cold auto antibodies   
    Could NOT agree more Neil.
  3. Like
    Malcolm Needs reacted to Neil Blumberg in Cold auto antibodies   
    We do not use enzyme treated cells when trying to detect or work up cold agglutinins.  No reason to enhance their reactivity in vitro.  If they are not detectable by routine LISS at body temperature or antiglobulin methods they are not of clinical importance.
  4. Like
    Malcolm Needs reacted to donellda in BloodBankTalk: Yt Blood Group System   
    I just answered this question.

    My Score PASS  
  5. Like
    Malcolm Needs reacted to exlimey in BloodBankTalk: Yt Blood Group System   
    I just answered this question.

    My Score PASS  
  6. Like
    Malcolm Needs reacted to SueR in BloodBankTalk: Yt Blood Group System   
    I just answered this question.

    My Score PASS  
  7. Like
    Malcolm Needs reacted to SbbPerson in BloodBankTalk: Yt Blood Group System   
    I just answered this question.

    My Score PASS  
  8. Like
    Malcolm Needs reacted to Arno in BloodBankTalk: Yt Blood Group System   
    I just answered this question.

    My Score PASS  
  9. Like
    Malcolm Needs reacted to Lauro in BloodBankTalk: Anti-RHAG4   
    I just answered this question.

    My Score PASS  
  10. Like
    Malcolm Needs reacted to Arno in BloodBankTalk: Anti-RHAG4   
    I just answered this question.

    My Score PASS  
  11. Like
    Malcolm Needs got a reaction from Arno in The CTL2 Blood Group System.   
    Thanks Arno; that was really helpful.  Yes, very well indeed thanks!
  12. Thanks
    Malcolm Needs reacted to Arno in The CTL2 Blood Group System.   
    Hello Malcolm, I hope you are doing good. I found this paper published in Blood in November 2023. The Cs a and Cs b Red Cell Antigens of the Cost Blood Group Collection Correspond to the HNA-3a and HNA-3b Neutrophil Antigens: Unexpected Twins with Implications for Sickle Cell Anemia - ScienceDirect 
  13. Thanks
    Malcolm Needs reacted to Mabel Adams in Website to support pregnant people with antibodies that may cause hemolytic disease in babies   
    ALLOHOPEfoundation.org  I just learned of this organization so wanted to share their name.  
  14. Thanks
    Malcolm Needs reacted to Mabel Adams in Website for support of pregnant patients with allo antibodies   
    ALLOHOPEfoundation.org I just learned of this organization so wanted to share their name.  
  15. Like
    Malcolm Needs got a reaction from BBlover in Cold auto antibodies   
    I was involved in one very unusual case (Win N, Needs M, Rahman S, Gold P, Ward S.  An unusual case of an acute haemolytic transfusion reaction caused by auto-anti-I.  Immunohematology 2011; 27 (3): 101-103.  DOI:  10.21307/immunohematology-2019-182.  

    This was caused by the unit being removed from the storage fridge and immediately transfused.  If I remember correctly, however, because of the reaction, blood was put through a blood warmer on the ward as a precaution after this.  I doubt very much though that it would be something that would be done on a regular basis.
  16. Thanks
    Malcolm Needs reacted to Neil Blumberg in Transfuse ABO incompatible RBCs in emergencies?   
    As you know a difficult question. The use of group O blood for non-O patients should be limited as soon as the ABO type is known, and ABO type specific given. There are some old admonitions to never transfuse type specific after X numbers of group O red cells or whole blood. This is nonsense, so do not follow this old precept.  Give only ABO type specific as soon as possible.
    As for giving non-O blood to O patients when all other options are exhausted, I would only do this if death were imminent due to bleeding, not ever for routine transfusion.  There are case reports of no hemolysis in such situations, including the one below from my original mentors from half a century ago.  Accidental error but no consequences.  But giving non-O blood to O recipients has the potential to cause rapid death in many instances. We don't know why there are such varied responses.
     
    Case Reports   Transfusion   . 1975 Nov-Dec;15(6):577-82.  doi: 10.1046/j.1537-2995.1975.15676082233.x. Unusual response to ABO incompatible blood transfusion
    D H Buchholz, J R Bove PMID: 1198685   DOI: 10.1046/j.1537-2995.1975.15676082233.x Abstract
    Three units of group A blood were inadvertently administered to a group O recipient during surgery without evidence of hemoglobinemia, hemoglobinuria, hypotension, disseminated intravascular coagulation, acute renal tubular necrosis, or other signs and symptoms of transfusion reaction. The recipient had normal concentrations of IgG, IgA, and IgM as well as complement (C3) prior to transfusion and anti-A agglutinins titered to 64 (titer of 128 by the antiglobulin technic). Seventeen hours following the transfusion, 28 per cent of the circulating red blood cells were group A (equivalent to 475 ml of packed cells); they were eliminated by day 5 without evidence of hemoglobinuria, hemoglobinemia or hyperbilirubinemia. Anti-A titers (antiglobulin) had risen from a posttransfusion low of 4 to 4,096 by day 10. After treatment of serum with 2-mercaptoethanol, however, hemolytic activity which was first noted on day 5 was lost and the antiglobulin titer dropped to 24 which suggested that most of the anti-A produced in response to the transfusion was IgM rather than IgG. The anti-A titer had dropped to essentialyy pretransfusion levels and the majority of anti-A present was IgM by day 91. The recipient suffered no untoward effects from the transfusion and was in good health three months following the transfusion.
  17. Haha
    Malcolm Needs reacted to Mabel Adams in Rh D type changing strength over time in same patient   
    Can not even Weak D type 1 patients be consistent in their ability to make anti-D?!??!  I still don't know why we got such different results than previously in gel. I verified that Ortho didn't change the anti-D clone in their gel cards between November and now. I guess this patient just wanted to mess with us.
  18. Like
    Malcolm Needs got a reaction from John C. Staley in Rh D type changing strength over time in same patient   
    In that case, I think that you would have been justified to have given "straightforward" D Positive blood in terms of a transfusion.  This is based on two papers from experts on the subject.

    Sandler SG, Flegel WA, Westhoff CA, Denomme GA, Delany M, Keller MA, Johnson ST, Katz L, Queenan JT, Vassallo RR, Simon CD.  It's time to phase in RHD genotyping for patients with a serologic weak D phenotype.  Transfusion 2015; 55: 680-689.  DOI:  10.1111/trf.12941.

    Sandler SG, Chen LN, Flegel WA.  Serological weak D phenotypes: a review and guidance for interpreting the RhD blood type using the RHD genotype.  British Journal of Haematology 2017; 179: 10-19.  DOI:  10.1111/bjh.14757.
    My own mentor, Joyce Poole told me that Weak D Type 1 individuals rarely produce an anti-D after transfusion with D Positive blood - although she had come across about three or four cases WORLDWIDE!!!!!!
  19. Like
    Malcolm Needs got a reaction from John C. Staley in Cold auto antibodies   
    I was involved in one very unusual case (Win N, Needs M, Rahman S, Gold P, Ward S.  An unusual case of an acute haemolytic transfusion reaction caused by auto-anti-I.  Immunohematology 2011; 27 (3): 101-103.  DOI:  10.21307/immunohematology-2019-182.  

    This was caused by the unit being removed from the storage fridge and immediately transfused.  If I remember correctly, however, because of the reaction, blood was put through a blood warmer on the ward as a precaution after this.  I doubt very much though that it would be something that would be done on a regular basis.
  20. Like
    Malcolm Needs got a reaction from John C. Staley in O Positive transfusion to unknowns in Massive   
    One of my own favourites is from Dr Brian McClelland MB ChB ND Linden FRCP(E) FRCPath, Consultant Haematologist, Scottish National Blood Transfusion Service, Edinburgh, UK, who said,

    "Transfusion has risks, but bleeding to death is fatal."
    I believe it was also him (although I could be wrong here) who said something along the lines of, "Giving perfectly compatible blood to a corpse is not a medical triumph!".
  21. Like
    Malcolm Needs got a reaction from Yanxia in Rh D type changing strength over time in same patient   
    In that case, I think that you would have been justified to have given "straightforward" D Positive blood in terms of a transfusion.  This is based on two papers from experts on the subject.

    Sandler SG, Flegel WA, Westhoff CA, Denomme GA, Delany M, Keller MA, Johnson ST, Katz L, Queenan JT, Vassallo RR, Simon CD.  It's time to phase in RHD genotyping for patients with a serologic weak D phenotype.  Transfusion 2015; 55: 680-689.  DOI:  10.1111/trf.12941.

    Sandler SG, Chen LN, Flegel WA.  Serological weak D phenotypes: a review and guidance for interpreting the RhD blood type using the RHD genotype.  British Journal of Haematology 2017; 179: 10-19.  DOI:  10.1111/bjh.14757.
    My own mentor, Joyce Poole told me that Weak D Type 1 individuals rarely produce an anti-D after transfusion with D Positive blood - although she had come across about three or four cases WORLDWIDE!!!!!!
  22. Thanks
    Malcolm Needs reacted to Mabel Adams in O Positive transfusion to unknowns in Massive   
    Maybe some of these references are helpful. 
    7. Selleng K, Jenichen G, Denker K, et al. Emergency transfusion of patients with unknown blood type with blood group O Rhesus D positive red blood cell concentrates: A prospective, single-centre, observational study. Lancet Haematol 2017;4:e218-24.
    8. Frohn C, Dümbgen L, Brand JM, et al. Probability of anti-D development in D– patients receiving D+ RBCs. Transfusion 2003;43:893-8.
    9. Gonzalez-Porras JR, Graciani IF, Perez-Simon JA, et al. Prospective evaluation of a transfusion policy of D+ red blood cells into D– patients. Transfusion 2008;48:1318-24.
    10. Tchakarov A, Hobbs R, Bai Y. Transfusion of D+ red blood cells to D– individuals in trauma situations. Immunohematology 2014;30:149-52.
    11. Yazer MH, Triulzi DJ. Detection of anti-D in D– recipients transfused with D+ red blood cells. Transfusion 2007;47:2197-201.
    12. Burin des Roziers N, Ibanez C, Samuel D, et al. Rare and transient anti-D antibody response in D(–) liver transplant recipients transfused with D(+) red blood cells. Vox Sang 2016;111:107-10.
    13. Yuan S, Davis R, Lu Q, et al. Low risk of alloimmunization to the D antigen in D– orthotopic liver transplant recipients receiving D+ RBCs perioperatively. Transfusion 2008;48:2653-5.
    14. Schonewille H, Haak HL, van Zijl AM. Alloimmunization after blood transfusion in patients with hematologic and oncologic diseases. Transfusion 1999;39:763-71.
    15. Goodell PP, Uhl L, Mohammed M, Powers AA. Risk of hemolytic transfusion reactions following emergency-release RBC transfusion. Am J Clin Pathol 2010;134:202-6.
    From this: Association Bulletin #19-02 - Recommendations on the Use of Group O Red Blood Cells (Revised) (aabb.org)
  23. Like
    Malcolm Needs reacted to Annan in BloodBankTalk: Cromer Blood Group System   
    I just answered this question.

    My Score PASS  
  24. Thanks
    Malcolm Needs reacted to Mabel Adams in O Positive transfusion to unknowns in Massive   
    Just to give credit where credit is due.  
    “Obtaining compatible blood for a corpse is not a therapeutic triumph.”  Ed Snyder, MD (Yale University) ISBTS meeting (Edinburgh) September 6, 2002
  25. Like
    Malcolm Needs reacted to SueR in BloodBankTalk: Cromer Blood Group System   
    I just answered this question.

    My Score PASS  
×
×
  • Create New...

Important Information

We have placed cookies on your device to help make this website better. You can adjust your cookie settings, otherwise we'll assume you're okay to continue.