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Malcolm Needs

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  1. Like
    Malcolm Needs reacted to Neil Blumberg in RBC Unit Cell Washer   
    I'd also add that none of the cell washers are FDA approved for washing platelets. We've been washing platelets on the 2991 for about 40 years :).  I believe there may be a paper on using the ACP-215 to wash platelets but as yet we do not have any hands on experience.  We have developed a manual method of platelet washing using a Sorvall centrifuge.  If your volume isn't too high, you might consider a manual wash method.  It takes a bit longer, but actually has higher recoveries (>90% vs. about 80-85% with the 2991). 
     
    Folks will tell you that washed platelets don't work clinically and the count increment is Washed Tx Leukemia.pdfWashed Tx Leukemia.pdflower.  The increment is indeed lower, but if you employ platelets that aren't ABO incompatible with the recipient and remove the supernatant, the clinical results are actually better than the clueless advice to give ABO major incompatible platelets routinely (e.g., group A to group O recipients).  The PLADO study had a bleeding rate using this abominable practice of about 70%.  Our bleeding rate avoiding infusion of ABO incompatible antigen or antibody is 5%, with or without washing.  A fourteen fold difference. So by all means give washed platelets to patients with severe or recurrent reactions, or avoid infusion of ABO incompatible plasma, and, if you believe our randomized trial data, to improve the survival of younger patients with acute myeloid leukemia. References attached if anyone is interestedWashing AML Greener_et_al-2017-American_Journal_of_Hematology.pdf.
    Washing Review IJCTM-101401-the-clinical-benefit-of-washing-red-blood-cells-before-transfusion.pdf Washing AML Greener Am J Hemat AML Washing Supplementary Figures and Tables.pdf Jill's washing paper.pdf Plt Washing Vo.pdf
  2. Like
    Malcolm Needs reacted to Bet'naSBB in How not to miss a weak reaction   
    I've been a BB'er for 35 years (at the same hospital)  my very first manager (who was a good,  seasoned BB'er) used to tell us........., "if you have to hunt for it - it's not there".
    As you become more adept at reading tube reactions - your eyes will not fail you!  Trust your gut.
    As for your technique - it all sounds good!  Practice with a few techniques to find the one that works best for you
    I "tilt and giggle", button up, The tilt helps with seeing Mixed Field - which we tend to see a lot here - It also helps with seeing "how" cells are falling off the button - are they chipping off or are they "swirling" off.....or is there a little of both?  (For some reason I always think of the "tail" of an old RPR test .....which probably dates me, LOL!)
  3. Like
    Malcolm Needs got a reaction from Kelly Guenthner in How not to miss a weak reaction   
    It sounds to me like you are doing everything that you should do, without either over-shaking the tube, or over-reading the contents.

    I am extremely glad that you are not using a microscope, as, if you did, you would almost certainly see the odd couple of red cells "kissing each other", even if they have been incubated in isotonic saline.

    The other thing is (and I speak with some 43 years of working in blood group serology) if the reactions in the tube are THAT weak, the chances of any atypical alloantibody that you might miss being clinically significant are absolutely minute.

    If you are still worried, however, get a more experienced worker to read your tests as well, until you feel confident.  That is how I learned when I started.
    I wish you the best of luck in your future career.
  4. Like
    Malcolm Needs reacted to mommymini1 in How not to miss a weak reaction   
    Thank you so much for your suggestion …I really appreciate it. 
  5. Like
    Malcolm Needs got a reaction from Jsbneg in How not to miss a weak reaction   
    It sounds to me like you are doing everything that you should do, without either over-shaking the tube, or over-reading the contents.

    I am extremely glad that you are not using a microscope, as, if you did, you would almost certainly see the odd couple of red cells "kissing each other", even if they have been incubated in isotonic saline.

    The other thing is (and I speak with some 43 years of working in blood group serology) if the reactions in the tube are THAT weak, the chances of any atypical alloantibody that you might miss being clinically significant are absolutely minute.

    If you are still worried, however, get a more experienced worker to read your tests as well, until you feel confident.  That is how I learned when I started.
    I wish you the best of luck in your future career.
  6. Like
    Malcolm Needs got a reaction from John C. Staley in How not to miss a weak reaction   
    It sounds to me like you are doing everything that you should do, without either over-shaking the tube, or over-reading the contents.

    I am extremely glad that you are not using a microscope, as, if you did, you would almost certainly see the odd couple of red cells "kissing each other", even if they have been incubated in isotonic saline.

    The other thing is (and I speak with some 43 years of working in blood group serology) if the reactions in the tube are THAT weak, the chances of any atypical alloantibody that you might miss being clinically significant are absolutely minute.

    If you are still worried, however, get a more experienced worker to read your tests as well, until you feel confident.  That is how I learned when I started.
    I wish you the best of luck in your future career.
  7. Like
    Malcolm Needs reacted to mommymini1 in How not to miss a weak reaction   
    Hi, I am a new bloodbanker and forgive me in advance for asking this question. My question is….I am afraid when reading tube agglutination I will miss a weak reaction and call it negative. I think it’s my technique. When I am reading a tube reaction after centrifuging ….I hold the tube so that the button is facing upwards and then I gently swirl while watching the button to see how it falls off. I look for any granules. Is this right ? Are there any tips on how not to over shake a tube and miss the weak agglutination . Thanks for reading my question. 
  8. Like
    Malcolm Needs reacted to BankerGirl in BloodBankTalk:Marrow transplantation safety and efficacy   
    I just answered this question.

    My Score PASS  
  9. Like
    Malcolm Needs got a reaction from John C. Staley in new edition of The Blood Group Antigen FactsBook. 3rd edition, 2012?   
    Hi Mabel,

    I contacted Jill and, although there was some talk about it, nothing has come of it yet.  The authors are aware, however, that the public would like a new version.
  10. Like
    Malcolm Needs got a reaction from Mabel Adams in new edition of The Blood Group Antigen FactsBook. 3rd edition, 2012?   
    Hi Mabel,

    I contacted Jill and, although there was some talk about it, nothing has come of it yet.  The authors are aware, however, that the public would like a new version.
  11. Like
    Malcolm Needs got a reaction from OxyApos in new edition of The Blood Group Antigen FactsBook. 3rd edition, 2012?   
    I don't know, although I have heard rumours.

    I'll contact Martin Olsson via Jill Storry, but you'll have to give me a couple of days.
  12. Like
    Malcolm Needs reacted to snance in Dr Patricia Tippett.   
    In my interactions, Patricia was a grand lady. So very kind to new talent and so gracious with her peers. I have some of the letters that she and Dr. Polly Crawford exchanged over the years regarding interesting cases and personal life happenings. They had a unique friendship! And, I have a talk at AABB in Nashville where I used a quote from her 1962 publication (!!) regarding anti-D in D+ patients with a negative DAT as missing a part of the D antigen, what we now identify with molecular methods as partial RHD. How absolutely thrilling that must have been to see new techniques prove and go further with historic theories. An excellent scientist, she is missed. Sandy Nance
  13. Like
    Malcolm Needs got a reaction from Judes in Transfusing O positive RBCLR to O negative   
    Yes, nationally in the UK, via BSH Guidelines.
  14. Like
    Malcolm Needs got a reaction from Judes in Dr Patricia Tippett.   
    It is with immense regret that I have to say that I learned yesterday that Dr Patricia Tippett died at the age of 93 on 1st August 2023.

    I first met Pat in the early 1970's, when I was a callow youth who had just left school and was working at the IBGRL when it was in Gatliff Road in London (when Dr Kenneth Goldsmith was the Director) and Pat was working in the opposite building in the MRC Blood Group Unit, then under Drs Rob Race and Ruth Sanger.

    Pat is probably most famous for her work on the Rh Blood Group System, including categorising the then know Partial D types and for realising that the RH genes were twofold; namely RHD and RHCE.
    She was. of course, one of the greats, but was as friendly to this callow youth as I started out in the profession, as she was to everyone who were already greats within the field.

    May she rest in peace.

  15. Like
    Malcolm Needs got a reaction from holly4874 in Dr Patricia Tippett.   
    Well, the thing is John, when I first left school, I started to work as a VERY, VERY junior member of staff at the International Blood Group Reference Laboratory when it was in London.  At that time Dr Kenneth Goldsmith was the Director, but others working there were Dr Carolyn Giles, Dr Elizabeth (Jan) Ikin, and a VERY young Joyce Poole.  Across the carpark was the MRC Blood Group Unit, run by Drs Rob Race and Ruth Sanger, where Dr Patricia Tippett worked, along with Geoff Daniels, for a while Christine Lomas (before she went to the USA and became Christine Lomas-Francis) and, for a short time, Dr Marcela Contreras (before she became a Dame and a Professor).  Just up the corridor was another set of laboratories run by Profs Walter Morgan and Winifred Watkins (and the janitor was one Sid Smith - after whom the SID Blood Group System was named).

    As you can imagine, with all those "NAMES" working in such a small area of London, it was like a magnet for all of the other world's greats to come and visit (I even met Dr Arthur Mourant and Dr Philip Levine on visits).

    With all these people, ALL of whom were amazingly helpful to even me, as someone who had just left school, what else could I do but fall deeply in love with the profession, and count my blessings from day one until I retired 43 years later.  I have been one lucky man.
  16. Like
    Malcolm Needs got a reaction from Ally in Transfusing O positive RBCLR to O negative   
    Was the physician happy for his/her patient to expire if there was literally no group O, D Negative blood available, or, indeed, to condemn some other patient to death if, for example, they were exsanguinating and also had an anti-D???????

    RIDICULOUS!!!!!!!  NOT you, the physician.
  17. Like
    Malcolm Needs got a reaction from albaugh in Dr Patricia Tippett.   
    Well, the thing is John, when I first left school, I started to work as a VERY, VERY junior member of staff at the International Blood Group Reference Laboratory when it was in London.  At that time Dr Kenneth Goldsmith was the Director, but others working there were Dr Carolyn Giles, Dr Elizabeth (Jan) Ikin, and a VERY young Joyce Poole.  Across the carpark was the MRC Blood Group Unit, run by Drs Rob Race and Ruth Sanger, where Dr Patricia Tippett worked, along with Geoff Daniels, for a while Christine Lomas (before she went to the USA and became Christine Lomas-Francis) and, for a short time, Dr Marcela Contreras (before she became a Dame and a Professor).  Just up the corridor was another set of laboratories run by Profs Walter Morgan and Winifred Watkins (and the janitor was one Sid Smith - after whom the SID Blood Group System was named).

    As you can imagine, with all those "NAMES" working in such a small area of London, it was like a magnet for all of the other world's greats to come and visit (I even met Dr Arthur Mourant and Dr Philip Levine on visits).

    With all these people, ALL of whom were amazingly helpful to even me, as someone who had just left school, what else could I do but fall deeply in love with the profession, and count my blessings from day one until I retired 43 years later.  I have been one lucky man.
  18. Like
    Malcolm Needs reacted to Neil Blumberg in Dr Patricia Tippett.   
    Hail and farewell.  
  19. Like
    Malcolm Needs got a reaction from noelrbrown in Dr Patricia Tippett.   
    It is with immense regret that I have to say that I learned yesterday that Dr Patricia Tippett died at the age of 93 on 1st August 2023.

    I first met Pat in the early 1970's, when I was a callow youth who had just left school and was working at the IBGRL when it was in Gatliff Road in London (when Dr Kenneth Goldsmith was the Director) and Pat was working in the opposite building in the MRC Blood Group Unit, then under Drs Rob Race and Ruth Sanger.

    Pat is probably most famous for her work on the Rh Blood Group System, including categorising the then know Partial D types and for realising that the RH genes were twofold; namely RHD and RHCE.
    She was. of course, one of the greats, but was as friendly to this callow youth as I started out in the profession, as she was to everyone who were already greats within the field.

    May she rest in peace.

  20. Like
    Malcolm Needs got a reaction from John C. Staley in Dr Patricia Tippett.   
    Well, the thing is John, when I first left school, I started to work as a VERY, VERY junior member of staff at the International Blood Group Reference Laboratory when it was in London.  At that time Dr Kenneth Goldsmith was the Director, but others working there were Dr Carolyn Giles, Dr Elizabeth (Jan) Ikin, and a VERY young Joyce Poole.  Across the carpark was the MRC Blood Group Unit, run by Drs Rob Race and Ruth Sanger, where Dr Patricia Tippett worked, along with Geoff Daniels, for a while Christine Lomas (before she went to the USA and became Christine Lomas-Francis) and, for a short time, Dr Marcela Contreras (before she became a Dame and a Professor).  Just up the corridor was another set of laboratories run by Profs Walter Morgan and Winifred Watkins (and the janitor was one Sid Smith - after whom the SID Blood Group System was named).

    As you can imagine, with all those "NAMES" working in such a small area of London, it was like a magnet for all of the other world's greats to come and visit (I even met Dr Arthur Mourant and Dr Philip Levine on visits).

    With all these people, ALL of whom were amazingly helpful to even me, as someone who had just left school, what else could I do but fall deeply in love with the profession, and count my blessings from day one until I retired 43 years later.  I have been one lucky man.
  21. Like
    Malcolm Needs got a reaction from Arno in Dr Patricia Tippett.   
    Well, the thing is John, when I first left school, I started to work as a VERY, VERY junior member of staff at the International Blood Group Reference Laboratory when it was in London.  At that time Dr Kenneth Goldsmith was the Director, but others working there were Dr Carolyn Giles, Dr Elizabeth (Jan) Ikin, and a VERY young Joyce Poole.  Across the carpark was the MRC Blood Group Unit, run by Drs Rob Race and Ruth Sanger, where Dr Patricia Tippett worked, along with Geoff Daniels, for a while Christine Lomas (before she went to the USA and became Christine Lomas-Francis) and, for a short time, Dr Marcela Contreras (before she became a Dame and a Professor).  Just up the corridor was another set of laboratories run by Profs Walter Morgan and Winifred Watkins (and the janitor was one Sid Smith - after whom the SID Blood Group System was named).

    As you can imagine, with all those "NAMES" working in such a small area of London, it was like a magnet for all of the other world's greats to come and visit (I even met Dr Arthur Mourant and Dr Philip Levine on visits).

    With all these people, ALL of whom were amazingly helpful to even me, as someone who had just left school, what else could I do but fall deeply in love with the profession, and count my blessings from day one until I retired 43 years later.  I have been one lucky man.
  22. Like
    Malcolm Needs reacted to donellda in Dr Patricia Tippett.   
    I am very sorry for your loss.
  23. Like
    Malcolm Needs reacted to Cliff in Dr Patricia Tippett.   
    Sorry for your loss and the loss to the community.
    Sounds like she had a long and fruitful life.
  24. Thanks
    Malcolm Needs reacted to Sherif Abd El Monem in Study With Me : Introduction to Blood Transfusion 1   
    Study With Me : Introduction to Blood Transfusion 2
    https://immunohematologymadeeasy.com/study-with-me-introduction-to-blood-transfusion-2/
  25. Like
    Malcolm Needs reacted to John C. Staley in Dr Patricia Tippett.   
    Malcolm, you appear to have know all the greats.  I had the honor of meeting a few  of them over the years and it's sad to witness the passing of an era of such amazing discoveries.
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