profbaud

Immediate spin crossmatching is the only crossmatching that can detect ABO discrepancies. We do electronic crossmatching for patients with no history of antibodies [past or present] and they have 2 blood types on file. We do gel crossmatching for those that don't qualify for electronic crossmatching. This is for detecting compatibility for pts with IgG and some IgM antibodies.

If the rouleaux is identified by the appearance of "stacked coins" under the microscope then I tell my staff that to see the dispersal of this formation, it is necessary to look under the microscope after the replacement of plasma with equal volumes of saline.

One other trick for solving this is to use the patient's serum and the patient's red cells. The Anti-B in the patient's plasma will not agglutinate the acquired B cells since they are really group A cells with a modification to the A sugar made by an enzyme from the Gram negative bacteria.

Depending on the type of Anti-D reagent you are using, if it is protein based, then a 6% albumin control is needed, if you are using monoclonal, then a saline control is sufficient.

Cord bloods are very stable specimens. I think the washing procedure needs to be checked out. If this is not adequate for the DAT, you can get a false negative. I take it this was done by tube method and not in Gel? DAT testing for cord bloods only requires using Anti-IgG AHG, and since the specimen should be an EDTA tube, complement is not an issue. Technical error is!

As Malcolm stated, if seronegative blood products are not available, using leukoreduced products is second best for reducing the chance of a CMV infection. We had a patient receive 50 units of leukoreduced blood before the doctor decided to do an allogenic stem cell transplant and he tested her for CMV IgG antibodies. I was truly surprised when it came back negative. Leukoreduction works! As to irradiation, this prevents graft vs host disease and is necessary for patients receiving blood from first degree family members, BMT or HSCT or intrauterine transfusions.

Yes that is the test we do [actually Hematology does it for us] for exchange transfusion.:cool:

The American Red Cross does them in St. Louis. Call the reference lab at 314-658-2084.

I know the American Red Cross in St. Louis MO does super DATs. I will get their number for you to call them.

I hope you are reading some of the suggest material before taking this exam. I took it 3 years ago after completing a SBB program and I know i wouldn't have passed it without the courses. Get Harmening's Transfusion book and review your coagulation since there is now alot of coag on it too. There is also a lot of math calculationsfor platelet counts, products and rbc recovery plus HLA questions. There is a SBB review book passing the first time by the volaris company that was helpful too. Good luck

Next question: What blood group system is associated with the Urea transport system and the what is the null group that can be found in the people of the Polynesian decent?

C4d is associated with Chido-Rogers system

we fulfill that CLIA requirement through proficiency testing of all operators on all shifts throughout the year.

Congratulations. Yes it is a hard exam and I too would never have passed it without going through a SBB program. I can recommend the program at Rush University.

Plasma frozen within 24 hrs. It's pretty similar to FFP but FFP is frozen within 8 hrs of collection.

If you know the Mother's blood type and she has a Negative AB screen, and you are able to conclude that the positive DAT is due to an ABO incompatiblity, then yes that's all the farther you need to go. If the Mother has a clinically significant alloantibody, then an eluate needs to be performed to confirm that Baby has HDN due to that antibody and not an ABO incompatibility

You mean TTP? ITP is treated with steroids. At our blood bank we try using regular FFP first [cheaper and more available]. If the patient doesn't respond, then we switch to Cryo-poor plasma, since it still contains the enzyme ADAMTS13 which is deficient or not working in TTP patients and they don't need the extra factors in reg. FFP.

Are you using Ortho's bioclone D reagent? It doesn't pick up all the weak D phenotypes like Immucor's Anti-D does. We see this discrepancy when we do retypes after putting the pt. specimen on the Provue. Then we end up doing a Du to confirm that the patient is Rh pos.

Are you using Mediware's HCLL blood bank system? At my last hospital they used that and it was set up that way so the night shift didn't have to do QC at 12:01 am otherwise it wouldn't let them report out STATs until QC was done. At that hospital we did QC our reagents on the day of use [including PEG, C3 etc] as per the AABB stds and CAP stds.

We accept ABO/Rh compatible units as long as they are CMV= or the doctor has to waive CMV= status if a parent is donating.

No we don't wash our neonatal pediatric red cell products unless it is for an exchange transfusion. We transfuse O Neg CMV=, LRPC AS1 units less than 30 days old and we irradiate the pedi pack aliquot just prior to transfusion.

Yes that is true. You can not phenotype a patient that has been recently transfused since you may be picking up the transfused cells phenotype and not the patient's. Our policy is if transfused in the last 3 months, you can't do it. We keep our crossmatch specimen's a month so sometimes we can go back to a pretransfusion specimen to do the typing. Otherwise we just note on the patient's record unable to phenotype due to recent transfusion and hope the patient doesn't come back in for another 3 months then you can do it.

The only requirement for a fetal screen specimen is that it be drawn POST partum. The timing doesn't matter so long as it's done within 72 hrs for administering RHIG.

I have used both the 2 and 3 cell Ortho screen and I personally love the 3 cell screen for several reasons. the Main reason is if you have an Anti-D you will have 1 cell negative to rule out some antigens. The same reasoning goes for multiple antibodies. If you have 1 negative cell to begin ruling out, then you can select cells that are homozygous for the remaining cells on your panel and decrease the time spent doing a complete panel. Any money save using a 2 cell panel will be spent in Tech time.

We do a Forward blood type on all infants from group O moms and Rh neg moms. If the Mom has a negative Antibody screen and if the baby is an A or B born to an O mom, then we just do an IAT on A or B reverse cells. That determines if Mom's Anti-A, Anti-B or Anti-A,B has crossed the placenta. A Lui freeze is outdated.