Jives

does anyone out there keep "A" thawed plasma to use with your first MTP shipment instead of wasting "AB" ???? since we give incompatible plts wouldn't it be ok to give say 2 incompatible plasmas on that first shipment? thanks!

most of the samples are drawn in a similar fashion, by stripping the tubing and heatsealing off a segment to test. however, if the unit is outdated the techs usually just cut open the segment attached to the bag and "pour" out what they need. thanks for the response!

we are currently having a problem with our apheresis platelets....upon issue when we collect our pH and plt count we have noticed a DRASTIC decrease of the platelet count and an increase in pH (i have never seen a pH increase with storage!!!).....the products are drawn on a COBE TRIMA and the platelet counts are run on 2 different sysmex xe 2100, pH is run on abl 800 flex.....nothing seems to be amiss about the machines? my question is could this happen if there was a problem with the ACD used or a problem with the lot of kit used???? here is the most perplexing example: drawn 8/8/11 plt count 8/9/11 approx 1500 on all 3 bags of a triple pH = 7.11 plt count 8/10/11 approx 1000 on all 3 bags and pH = 7.63 any ideas what could be happening??:confused: thanks, jane

Does anyone know of an "HTLA" antibody that gives mixed field reactions (besides Sda..urine inhibition did not work) (not Lub pt was still pos with Lub- cell) our reference lab got neg with LISS, but when i retested here it was still pos (maybe we use different manufacturers?!?) thanks for your help, jane:cool::cool::cool: getting ready to go on vacation so don't get mad if i don't answer right away, i'll be fighting off moschitoes in the north woods of wisconsin:D:D:D

thanks everyone for your replies, we do have a high percentage of cancer patients here which would explain the rouleaux problems, but why do they seem to get stronger after time spent in frig, they are not cold antibodies since they go away with saline replacement (even using cold saline)??

i apologize if this question has already been posted... we have noticed a substancial increase in rouleaux since we started using EDTA plasma (i assume due to the increase in compliment-protein) the rouleaux seems to get stronger if the plasma is cold, but easily goes away with saline replacement. i just found out at least one of the techs here routinely warms up her plasma before doing any IS crossmatches...so my question is: does warming the plasma to 37 degrees decrease the detection of abo incompatibilities? just wanted to make sure we can't get "sited" for it:confused: thanks

thanks everyone for your replies! on your patients that have antibodies, do you use the original specimen to crossmatch or do you re-draw on day of surgery and use that to crossmatch? i couldn't find anything that set a limit on how old a specimen can be and still be used for AHG crossmatching!

we are getting ready to implement a policy that allows us to draw patients up to 30 days before surgery if they have not been transfused or pregnant in 3 months. what i was wondering is how others handle patients in this catagory that have a positive ABS. also, if you use armbands, does it go home with the pt and you hope they bring it back or does it stay with the chart and get applied to pt day of surgery? thanks, jane :confused:

every once in a while, when looking for more specimen for an antibody work-up, the only plasma or serum that is available has been drawn in a tube with a gel separator...is it ok to use this plasma or serum or can contact with the gel cause false positives? i cannot find a reference to this in the technical manual. thanks for your help:)

how do you handle OB titer specimens. do you just do the titer since that's what was ordered or do you also rule out additional antibodies each time...and if so, are you allowed to charge for the addl work??:confused:

we saw probably 3-4 in about a 2 year span from 1999-2001 (i'm guessing here...i would have to pull archived work-ups to be more accurate!) but it was enough of a problem that we got cefatetan taken out of our pharmacy! most were mom's that presented a few weeks after c-section and were anemic (drug was given prophalactically before surgery) and one happened to be some type of GI surgery and the doc's wife was an OB who suggested to him that the anemia after surgery might be do to cefatetan!!! they really do listen at "grand rounds"!

do you use the original specimen or the previous specimen as your control for prenatal titers? 1. original 2. previous

When we find an antibody on pregnant women, we call the doc to see if they want a titer and then freeze aliquots to run in parallel with subsequent titer samples on the patient. I was wondering if we should instead be using the previous specimen as our parallel instead of always using the original specimen. What does everyone else do and why? thanks in advance, jane

Hey Ann......thanks so much for the answer....it will help when i get together with my medical director to talk about how to handle these!!!! i don't know if your interested but there was an article in "Transfusion and Apheresis Science" August 2006 called "Comparative sensitivity of solid phase versus PEG enhancement assays for detection and identification of RBC antibodies" of all the positives they saw almost 35% were neg with PEG!! thanks again, jane:)

dear AMcCord i know this is a late response, but we are having more and more (3 in the last two days!!!) trouble with these and i was wondering if you might tell me how you are handling these.(what all do you do to work them up)...in particular how do you report them to the physician?!!?:confused: and do you tell them they (solid phase reactive antibodies) are clinically insignificant?!?!? do they ever call to say "What are these? " thanks, jane

Hi all, we are having a recurring antibody problem on our ECHO and i was wondering if anyone else is see this: ECHO screen strongly pos: 3-4+ PEG screen neg-2+ LISS screen neg cold screen 1-3+ only at 4 degrees DAT neg we have seen 6 of these in the last three weeks, i thought maybe it could be a strip problem but one of them had an ECHO panel run and it was 3-4+ also the only thing we can find is a cold auto at 4 degrees, but i thought ECHO did not detect these!! i am going to call immucor again, but they haven't been too helpful to this point:cries:

malcom, i read in another thread that HTLA's do not adsorb out of the plasma....is this true and where can i read up on it thanks, jane

malcom, i read in another thread that HTLA's do not adsorb out of the plasma....is this true and where can i read up on it thanks, jane

do they exist?? can they be bought or do you guys just collect cells from old panels??:tongue: thanks, jane

Couple of questions concerning warm auto work-ups: 1. how do you tell the difference between a warm auto that won't absorb out of your plasma specimen and a warm auto + HTLA? 2. when you have a patient who has been recently tx'd and can therefore NOT do an auto absorption, does anyone use a phenotypically matched cell to absorb instead of the traditional differential absorptions with 3 different cells? thanks for the help, jane:)

you guys are hillarious...i have a medical director that calls anti-Sda..."some dumb antibody"

sorry, but i forgot to mention the rhogam she got in sept so that would account for the low titer in dec......it just surprises me that the titer of rhogam can be 32 even if it was just 5 days post injection thanks, for the help

malcom, what do you consider a high titer....i had a 1:32 5 days after Rhogam and 5 months later it is barely 1:1 so it most probably was due to the Rhogam.

we use a total of 3 cells to rule out an antibody and one of them should be homozygous

when you find rouleaux on IS crossmatch do you perform saline replacement only or do you run an AHG crossmatch?