transfusionpgi

We are a small facilityand don't have gene typing facility around also. Can anybody please share the SOP for retic typing? Thanks in anticipation.

we do grade mf and I agree with rcurrie that grades are extremely helpful in picking up weaker groups. One more thing, has anybody noticed these mf reactions on "slide"? These appear 'beautiful' and you can actually see them getting stronger from "within-out" and differentiate them easily from weaker reactions say 1+ or 1+(w), especially for techs who are not very interested somehow in picking these reactions!

Dear TimOz, Very thanks for sharing the useful information. Your description was really enlightening! We have decided to implement the imported panel with 'retrospect' use of "in-house" panel, in case something comes positive while screen is non-commital. We would love to be a part of your study group. Kindly provide your mail I.D. Mine is bloodbank.abmh@adityabirla.com

Electronic issue is still a 'far cry' for us. I am sure your LIMS must be validated nicely! Are you following some guidelines? We plan to continue it (AHG Xm) till we either have our cell panel or population profile done (for ags). Now, there again is a 'news' for you! Blood supply here doesn't have segregation as blood suppliers and transfusion centres/ hospitals (more of it some other time), but ...Yes, labeling and other processes are well validated and we don't find these kind of errors anymore (yes, we did have them initially though)

Dear Galvania! You are bang on target! We indeed use Diamed gel cards and send anything which cannot be resolved at our end to Diamed people. How do you know that they have their headquarter in Gurgaon? Anyway, since Diamed is one of the stake holder in the entire seen, their view is bound to be biased and in fact is biased, as they do not even recommend Aisan Diacell panel (which I presume is short in supply and thus they don't mind dispatching whatever is available). You seem to be related to Diamed in someway, is it?

what is the right time for antigen phenotyping after a blood transfusion, especially in chronically transfused recipients, like those with tx dependent thalassemia, CRF on hemodialysis, etc. (We know that type of agglutination pattern in tube or gel will give a clue to ****- or heterogenity of rbc population, eg. mixed field, weaker agg, etc. Still what is the "IDEAL' time interval after last tx?)

Dear Malcom, I fully agree with you and just to complete your quote - "Those who don't learn from history are destined to re-live it" was originally written as ""Those who don't learn from history are liable/ prone to repeat its mistakes".

I was searching on google for some answers regarding one of clinico-immunohematology problems that I faced one day. That's how I reached this site, looked at the contents and topics posted - got hooked to it from then on.

Hi Lara! Had I been in your place, I would've recorded the finding and given the test result as negative, keeping in mind that patient didn't have anything clinically suggestive. Some studies quote positive DAT to the tune of 10% of hospitalized patients without any significance. Recording the finding (i.e. + and then negative over 5 min) will help you correlate similar findings in future. Anyhow, what was the result with anti-IgG (AHG), if it was done at all? Also, do you use only tube technique only or some other also? Gel can provide better understanding with mf type of reactions.

You see, engeekay was right, better to discard one unit than be in doubt. We too discard any sample coming positive by any (be it rapid, ELISA, etc.) technique. Also, which ELISA kit are you using? This type of result can come due to delay in tesing, sample error, sample storage conditions, technical error, using low sensitivy ELISA kits, etc. There are many good rapid tests available in the market which perform better than some ELISAs. Amongst all Ortho ELISA seems to be better than the most in the lot. Thanks for sharing the info.

Thanks for the reply. You are correct. We still don't have antigen profile available for our population. Big studies are underway for the same. This will help companies develop indigenous cell panel. Also, study (done at one big centre in India, and not by us) did find one anti-Mi(a) in the patient population. We are beginning this exercise with our population. Till now we were doing Grouping and crossmatching without ab screen for our patients.

Thanks for the reply. We are still a new set up and what I quoted was from 2 good centres in India (both are teaching institute with transfusion courses running there). Author of the study only said, "missed abs were clinically significant", without mentioning the specificity. We are planning to start the ab screening for all our IP patients and this was recently OKeyed by our Hospital Transfusion Committee. Thus this query of mine. Do you routinely crossmatch (AHG) patient samples negative on ab screen? Or is it just IS/ Electronic Xm?

Dear Colleagues, I would like to get your comments on the topic. We are a tertiary care health set up in Western India and want to start ab screening for all patients who might require blood transfusion. Just to appraise you of situation in our part of the world regarding Blood Banking: 1. Antigen profile of the populatin is not available yet. Whatever studies have been done are not true representation of the entire population. 2. Only fewcentres are aware of (still cannot say well versed) the immunohematology techniques applicable and still few practice them. This to the extent, that even tube technique for cross matching (with or without AHG) is not know to many blood banks. We group & type our patients for ABO and Rh(D) and perform gel crossmatch. Any ab found is resolved 'retrospectively' . Now, coming to the query - Studies done in India (2-3) have shown that sensitivity of (picking ab by) currently available cell panel is only 80% i.e. no ab on cell panel still crossmatch incompatible. These were for clinically significant abs. Q1) So what is the solution? How do we go about it? Q2) what are the advantages of ab screening in pre-transfusion sample in this scenario? Thank you