Malcolm Needs

I sincerely hope that you would also contact your blood supplier to let them know that there is a high risk of bacterial infection, as there may well be other blood components from the same donor that may yet still be untransfused to a patient, and which should be immediately put into quarantine.

I just answered this question.

My Score PASS  

I just answered this question.

My Score PASS  

Extended cross-match, UNLESS, the history of which other hospitals the patient has been treated is known.

Of course, in the UK we have a national database of patient's antibodies, which makes life an awful lot easier, even if the data is just a "snap shop".

I just answered this question.

My Score PASS  

I had the ENORMOUS honour of lecturing on a course with Sue in Cressier in Switzerland in 2015, and I can assure everyone that she is a consummate lecturer, who has the ability to get across the most difficult subjects, and make them fully understandable to even the most junior of staff.

We send cards to physicians (for their patients, if they like)  because it is our responsibility to patients, not because it works well.
If anyone has better ideas, please share them. Obviously a national database would be best.
Doing absolutely nothing is not an option from our standpoint.

Thanks my friend

There was no recording in these "good old days" unfortunately.
I had the chance to spend a few days with Sue some weeks ago (we were lecturing at the same event) and I should say that on the top of what Malcolm wrote which is very true, she is such a wonderful person, as Malcolm is!

I had the ENORMOUS honour of lecturing on a course with Sue in Cressier in Switzerland in 2015, and I can assure everyone that she is a consummate lecturer, who has the ability to get across the most difficult subjects, and make them fully understandable to even the most junior of staff.

I had the ENORMOUS honour of lecturing on a course with Sue in Cressier in Switzerland in 2015, and I can assure everyone that she is a consummate lecturer, who has the ability to get across the most difficult subjects, and make them fully understandable to even the most junior of staff.

Not as far as I know.  Ask Arno.  There may still be a few course books about.

I had the ENORMOUS honour of lecturing on a course with Sue in Cressier in Switzerland in 2015, and I can assure everyone that she is a consummate lecturer, who has the ability to get across the most difficult subjects, and make them fully understandable to even the most junior of staff.

In the UK, it is STANDARD practice in all laboratories that I know to use either the phrase "No Antibodies Detected", or, more frequently, "No Atypical Antibodies Detected", as the latter also includes such things as the iso-antibodies of the ABO and H Blood Group Systems.  Indeed, some go further still and use "No Atypical Allo-antibodies Detected", as this covers such findings as an auto-anti-H, auto-anti-I and auto-HI, as well as the ABO and H iso-antibodies.
These phrases do not mean that there are no atypical allo-antibodies detected.  It would be an incredibly rare set of screening cells and antibody identification panel cells that would both express, for example, the HJK antigen, or any other genuine low prevalence antigen.
In some cases, where an atypical allo-antibody IS detected, but it is known to be clinically-insignificant (such as anti-Kna), we may use the phrase "No Clinically-Significant Atypical Allo-antibodies were Detected" (or words to that effect).

One thing is for certain, and that is that a UK Reference Laboratory (and most hospital laboratories) worth their salt would report out as "Negative", or "No Antibodies", although, even using the phrases I've quoted above, occasionally the phrase, "All Clinically-significant Allo-antibodies have been Ruled Out using etc.", or words to that effect.

MIND YOU - you have to remember that I am RENOWNED for being a pedant - but I learned it from a few good sources; Peter Issitt, Carolyn Giles and Joyce Poole (to name but three).

The trouble is that, if the antibody happened to be an anti-Jka or, worse, an anti-Vel, the resulting rise in titre, following an anamnestic response, could be fatal on rare occasions.

Believe me when I say that you are lucky!  

In the UK, such a unit would be offered to the National Frozen Blood Bank, and would only be frozen AFTER a thorough aseptic wash, followed by addition of a chemical to prevent the formation of sharp ice crystals, and then  more washing upon thawing.  There would be no allo-anti-Kpb left!

The trouble was that, in those days the anti-D immunoglobulin was known as "anti-D for Mum's Bums" in the UK, as the shot was given in the gluteal muscle.  But, there was an awful lot of fat in that muscle, so the anti-D had a habit of "staying there", rather than being adsorbed into the blood stream.  This meant that, even when the dose of anti-D immunoglobulin was calculated from the Kleihauer-Bekte test, the actual dose reaching the circulation was far lower than the calculated dose, and women used to produce allo-anti-D as a result.  Nowadays (at least in the UK) the shot is given in the lateral deltoid muscle, where there is a good deal less fat, and so the shot is adsorbed into the circulation much easier, and so there are fewer cases of maternal allo-anti-D.

I realise that this is a very vague explanation, and that there are many other causes of anti-D immunoglobulin being less than effective (such as giving it to the father, or even to the ambulance staff (SHOULD be unbelievable, but is actually true), but it does show just how complicated such a simple thing as this can be.

I would be wary of relying on enzyme-treated red cells, as a negative reaction could be due to the cognate antigen being denatured by the particular enzyme used.

Agreed.  The ONLY time we might perform anything like a post-partum screen is if the baby's DAT is positive, and the baby has clinical signs of HDFN, but the mother has not been shown to have an alloantibody in her circulation during the pregnancy.  In such a case, we may well test the maternal plasma (or an ABO adsorbed and eluted sample of the plasma) against the paternal red cells (if available) to see if the antibody is directed against a low prevalence antigen expressed on the paternal red cells.  Having said that, however, this would only be useful in a further pregnancy with the same male, as providing the present baby with a unit for top-up or exchange would be easy if the antibody is directed against a low prevalence antigen

In the UK, it is STANDARD practice in all laboratories that I know to use either the phrase "No Antibodies Detected", or, more frequently, "No Atypical Antibodies Detected", as the latter also includes such things as the iso-antibodies of the ABO and H Blood Group Systems.  Indeed, some go further still and use "No Atypical Allo-antibodies Detected", as this covers such findings as an auto-anti-H, auto-anti-I and auto-HI, as well as the ABO and H iso-antibodies.
These phrases do not mean that there are no atypical allo-antibodies detected.  It would be an incredibly rare set of screening cells and antibody identification panel cells that would both express, for example, the HJK antigen, or any other genuine low prevalence antigen.
In some cases, where an atypical allo-antibody IS detected, but it is known to be clinically-insignificant (such as anti-Kna), we may use the phrase "No Clinically-Significant Atypical Allo-antibodies were Detected" (or words to that effect).

One thing is for certain, and that is that a UK Reference Laboratory (and most hospital laboratories) worth their salt would report out as "Negative", or "No Antibodies", although, even using the phrases I've quoted above, occasionally the phrase, "All Clinically-significant Allo-antibodies have been Ruled Out using etc.", or words to that effect.

MIND YOU - you have to remember that I am RENOWNED for being a pedant - but I learned it from a few good sources; Peter Issitt, Carolyn Giles and Joyce Poole (to name but three).

Believe me when I say that you are lucky!  

Extended cross-match, UNLESS, the history of which other hospitals the patient has been treated is known.

Of course, in the UK we have a national database of patient's antibodies, which makes life an awful lot easier, even if the data is just a "snap shop".

I meant that they would NOT report it as "Negative", or "No Antibodies", but WOULD report occasionally as "All Clinically-significant Allo-antibodies have been Ruled Out using etc.", or words to that effect.

In the UK, it is STANDARD practice in all laboratories that I know to use either the phrase "No Antibodies Detected", or, more frequently, "No Atypical Antibodies Detected", as the latter also includes such things as the iso-antibodies of the ABO and H Blood Group Systems.  Indeed, some go further still and use "No Atypical Allo-antibodies Detected", as this covers such findings as an auto-anti-H, auto-anti-I and auto-HI, as well as the ABO and H iso-antibodies.
These phrases do not mean that there are no atypical allo-antibodies detected.  It would be an incredibly rare set of screening cells and antibody identification panel cells that would both express, for example, the HJK antigen, or any other genuine low prevalence antigen.
In some cases, where an atypical allo-antibody IS detected, but it is known to be clinically-insignificant (such as anti-Kna), we may use the phrase "No Clinically-Significant Atypical Allo-antibodies were Detected" (or words to that effect).

One thing is for certain, and that is that a UK Reference Laboratory (and most hospital laboratories) worth their salt would report out as "Negative", or "No Antibodies", although, even using the phrases I've quoted above, occasionally the phrase, "All Clinically-significant Allo-antibodies have been Ruled Out using etc.", or words to that effect.

MIND YOU - you have to remember that I am RENOWNED for being a pedant - but I learned it from a few good sources; Peter Issitt, Carolyn Giles and Joyce Poole (to name but three).