Byfaith

I agree with Malcom - not much value, if any. I, too, have done many such noninformative adsorptions.
In a recently-transfused patient, there is perhaps a very remote chance that (allo)adsorptions on an eluate would reveal a "only on the cells, not in the serum yet" newly formed antibody. This might be important if the clinicians suspect faster-than-normal red cell loss, but it would be very difficult to differentiate from the typical increased red cell demise seen in patients with warm autoantibodies.

In our case it would be not totally trusting your own work and asking a second tech to double check with a new segment.

I did allo-adsorptions on eluates for quite a while and never once detected anything in the adsorbed eluate.  My own experience suggests that it is a waste of time and resources, but others may disagree.

We don't recheck antigen typings here in our hospital in Canada. The typings that have been performed at Canadian Blood Services, are embedded in the barcode on the bag, with all negatives printed on the End User Label. Every unit is antigen typed for K so if it isn't printed on the bag the unit is K Pos. Antigen typings we do are all linked to the unit through barcode. The reason of, "We were typing a lot of units and may have mixed them up", is not acceptable in a blood bank setting. Go work in a different department if you can't organize yourself. Anyway, there is also a full gel or whatever you use crossmatch at the end of that phenotyping, as long as the antibody is reacting, an anomaly could be discovered there. You have to have a little faith that people before you are doing their job properly, or you can cause yourself a lot of undue stress.

Lots of users on this Forum are in the same place and I'm sure they have some good advice on how to approach this issue. However, I would be cautious of implementing an optional process that potentially calls into question the quality of previous work.

In my opinion, you can run an antibody screen on the last wash instead of a full panel.  Of course if the screen is positive, you'd want to run a full panel.  I have never known the last wash screen to be positive.

You can't do a strict prewarmed in gel, though rarely I will prewarm my IgG card.  If I am using prewarmed technique I use tubes.

In our BB system (Cerner) the blood status would first be considered Available, then Crossmatched, Dispensed (pick up by nursing), and presumed Transfused 30min after Dispense.  We do somewhat use Dispense and Issue interchangeably in some of our SOPs.   As far as when the blood is crossmatched and ready for pick-up, we would either say the blood is ready or crossmatched complete.

That thought crossed my mind also - 86yr old woman - who knows?! 
Regarding the clones in Anti-D reagent, the results in 2009 were 3-4+, but I guess strength doesn't matter if a clone is either going to react or not react with this particular patient.  Interesting case, whatever it is!

So after an unforunate (and reportable) event where an ECC patient got transfused with RBCs instead of intended FFP, we made changes in Cerner.  There is a crossmatch orderable and a seperate Transfuse orderable - the Transfuse order generates a page on the Blood Bank printer, which must be on hand prior to issue.  Exceptions for emergency, MTP, and OR cooler issue.  Babysitting at its best!
 

At the beginning of the testing process, ProVue warns the user with a disclaimer displayed onscreen that hemolysis, icterus and turbidity (wbcs, lipemia) may interfere with reading of a sample.  ProVue takes an image of the gel well and does a gray-scale analysis. The presence of turbidity, hemolysis and icterus would darken the image and prevent analysis due to lack of contrast. 
Byfaith was asking if her current criteria is too restrictive and for options for sample rejection criteria when using automated gel testing.  My suggestion was to let the machine determine sample acceptability.  Using a visual color chart comparision process that was probably developed for manual tube testing ignores the machine's capability to do sample rejection that is more consistent and appropriate for the machine.

Transfusion reaction workup is a whole 'nother animal. If I get a post-transfusion specimen that is hemolyzed, the first thing I do is ask the phleb if the draw was difficult. If it was, I send up someone else to obtain a new specimen. If we can't get a clean specimen, then that information is part of the documentation and taken into consideration with the interpretation of results.

There is older literature referring to the concept of hemolysis as a positive reaction interpretation.  I believe this is relavant only to tube testing.  There is also the fact that using EDTA samples complement does not come into play and therefore no hemolysis of test cells? 
I believe our cutoff is random, going along with our chemistry laboratory cutoff.

I doubt our computer could do this either (Cerner).  I am puzzled by the requirement even when the discrepancy is resolved - it would seem to me it no longer "exists" once a valid typing is performed, or it is confirmed that an Rh Pos patient got Rh Neg blood.  Any other thoughts on this?  

The way I read this, is "if discrepancies exist".  Not if discrepancies existed (in the past).  So if you have a discrepancy and resolve it, it does not exist anymore.  So if you can't resolve the discrepancy currently with other techniques, a serologic crossmatch would be required, but if you followed through with your procedure to resolve the discrepancy, it is no longer a discrepancy.

There is a good video on YouTube done by Hugh Laurie  - "The Strange Case of Penny Allison".  It humorously present a host of potential transfusion/labeling errors.  Maybe humor is not what you want, but it does get the point across!

There is a good video on YouTube done by Hugh Laurie  - "The Strange Case of Penny Allison".  It humorously present a host of potential transfusion/labeling errors.  Maybe humor is not what you want, but it does get the point across!

There is a good video on YouTube done by Hugh Laurie  - "The Strange Case of Penny Allison".  It humorously present a host of potential transfusion/labeling errors.  Maybe humor is not what you want, but it does get the point across!

We have an orderable test called "Antibody History" that places the results in the patient record, but it is clear that the antibody was identified elsewhere.

We have an orderable test called "Antibody History" that places the results in the patient record, but it is clear that the antibody was identified elsewhere.