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May 2024 Challenge

rebeccarjthomas

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Everything posted by rebeccarjthomas

  1. rebeccarjthomas
    We had a patient referred to our Ref Lab that had an anti-D reactive strongly in Solid Phase with all D+ cells but Ro cells. Customer was certain there was an unusual aby here.
  2. rebeccarjthomas
    Yes -definitely get rid of the bleach! Also - bleaching plastic saline bottles may cause chemicals to leach out of the plastic - who knows how that would affect your testing!
  3. rebeccarjthomas
    This is not an uncommon situation. For quite a few years, I was in charge of a prenatal testing lab at Memorial Blood Centers. One of the services we provided was Kleihauer-Betke testing. For quite a few years we repeated FMH screens on samples submitted for Kleihauer-Betke testing due to pos FMH screens when the Kleihauer-Betke test was negative. We followed the FMH screen procedure published by Betty Sebring, who, also, worked at Memorial. In all cases, the FMH screen test in our hands was negative.
  4. rebeccarjthomas
    Quite a few of our customers use the ECHO. At times they report positive reactions, sometimes strong, that we cannot duplicate using manual Solid Phase. My understanding is that: On the ECHO - pt. sample is added prior to LISS. Manual Soloid Phase - LISS is added prior to patient sample. Has anyone looked at this difference specifically? I don't think I've seen anything published on manual versus ECHO Solid Phase testing. Thanks, Becky
  5. rebeccarjthomas
    AIMS sponsored by SCABB in the spring. Great meeting!
  6. rebeccarjthomas
    Molecular people would agree with your first statement. rjt
  7. rebeccarjthomas
    WHen using EGA treated cells for Weak D testing, we run a Weak D positive cell as a control. This is a cell that you can purchase. RJT
  8. rebeccarjthomas
    Mike - DOn't you remember learning the Kleihauer technic all those years ago when you rotated thru Prenatal Lab at Memorial? Memorial has never read Kleihauers using oil. Hope you are well - give my regards to Marsha. You should get Dr. Megan to invite you to ICII. IT's in MN this year. Becky Thomas
  9. rebeccarjthomas
    Wow- this sure sounds like age discrimination! What you really have is a long term training issue.
  10. rebeccarjthomas
    Well how about when you suspect you may have a weak aby present - use ads. and elution to concentrate. (Adsorb a large volume of serum versus a smaller volume of cells say a ratio of 3:1 using an untreated adsorbing cell; elute back post adsorption to concentrate suspected weak aby).
  11. rebeccarjthomas
    Well - there again I think you need to think about how sensitive the test method is that you are using. Some labs, for instance ARC IRLs, routinely rule out aby on heterzygous cells when testing in PEG, enzymes, GEL or Solid Phase.
  12. rebeccarjthomas
    What about the possibility that the child was sensitized by Mom if Mom RH Pos? Jane Swanson had a person with, I believe anti-Fya, that the Mom seemed to be the only possible explanation for sensitizing event.
  13. rebeccarjthomas
    INteresting. I worked for a long time at a facility where we repeated adsorption studies on patients with WAA every two weeks - recommending as compatible or more compatible than ac during the intervening time. However, we had a patient that developed a new antibody (anti-Kell) within one week post adsorption study. So at that time, we revised our policyon repeat adsorption studies to repeating once every seven days. Of course, one policy just like one technic serve as our best, thoughtfully considered practice - but exceptions happen - like your patient. Wow, did you just get a phenotype and start giving this patient phenotypically matched units?
  14. rebeccarjthomas
    Malcolm, Say if you com eto MN (maybe for the ICII meeting next June) you could take a side trip up to northeastern MN. In Ely , gateway to the Boundary Waters Canoe Area, there is a fascinating well established Wolf Center. OR - you could read about it on the web. Maybe they would have some ideas to save "your" facility. Becky THomas P.S> I grew up in Ely.
  15. rebeccarjthomas
    I agree - would be great Malcolm. Becky Thomas
  16. rebeccarjthomas
    Hi. I would probably make some monolayers with fresh RBCs. This would possibly tell me if the patient sample was actually reacting with RBC agn, or reacting to the stroma (or some alteration to RBC agn when stroma prepared and layered onto the microwells). If the tests were tests were neg with the fresh cell monolayers, I would report that the patient sample reacted with all commercial solid-phase cells tested (stroma) but was neg with fresh cell monolayers and tube tests. I would add a comment that patient serum reacting with stroma - no significant aby present. Happy Holidays! rjt
  17. rebeccarjthomas
    For many years, I worked in a Ref Lab that chose to QC each of our In-house panel cells daily. This was done in response to an inspector's suggestion. We made sure that each panel cell was used in some part of the general daily QC (o cell for anti-AB, test cells for each enhancement with weak aby, neg cell with AHG reagents). Becky
  18. rebeccarjthomas
    Well, I worked for many years in a Ref Lab that routinely tried to duplicate the method used by the customer. This was a starting point, often reflex testing in PEG. Currently I'm working in a Ref Lab that chooses to use two methods on each sample. Many of our current customers use the ECHO. We are going to be performing manual solid phase panels in an attempt to see if we are missing any thing by tube and/or gel that our customers are picking up. As to Malcolm's comment about the insignificance of something detected only by ECHO - I disagree. Would you not honor an anti-Jka only found in ECHO? Becky Thomas
  19. rebeccarjthomas
    Contact your local blood supplier - they may be willing to help with this. Becky Thomas
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