gonneb25

We are currently testing the neonatal DAT's in IgG gel cards only, and are contemplating moving to the polyspecific card. Does anyone else test for both Complement and IgG in neonates? Second question: we will be changing our transfusion reaction workup DAT to the poly card - but when doing the breakdown is required (pos poly test in gel) we will do the IgG in gel and the complement in tube. Is anyone else doing it that way? There currently is no complement only gel card. Thanks!

We only repeat the panel every 6 months unless we see increased reactivity in the screening cells and/or an incompatible antiglobulin crossmatch. We have not found any issues with this method. I had talked to one lab years ago that said they only do a new panel if the crossmatch is incompatible. After reviewing the other answers I think our process may raise a few eyebrows, but we did extensive validation. Also, we are using gel technology that I believe to be very sensitive and will not miss many clinically significant antibodies in our 13 years of experience with it. I am not sure what technology the other responders to this question are using.

We use antibody positive units, but have restricted their use to non-pregnant, non-heme/onc, non-dialysis patients. We have given units with anti-K to some patients who then have a positive antibody screen 3 days later showing anti-K. The staff are not happy when that happens!

I am conducting this poll to see how many facilities are still looking for cold aggs in patients undergoing cardiopulmonary bypass in Open Heart Surgery. Please respond using the answers below: 1. No, we do not test separately for cold aggs on anyone 2. yes, we test for cags for OHS pts only. 3. yes, we test and also report out thermal range. 4. yes, we test but only tell surgeon cags are present. 5. we routinely look for cags on all pts. Thanks! Barb G

we have had a few this year. There was a JCAHO sentinel event alert about hyperbilirubinemia a few years ago and we have noticed that they seem to be exhanging at a lower bili level than before. But, we also have a very active neonatal intensive care nursery and they tend to exchange the premies at a lower level also. We have had a few exchanges due to anti-c.

Currently, we always give CDE neg red cells to patients with anti-D. This used to be easier when the reagent company sold anti-CDE. Now it is backordered so we are using anti-C and anti-E. My question: are most hospitals providing CDE neg units? And, are most places screening units for patients exhibiting anti-D due to RhIg? We currently screen the units, but only perform ISXM's as the antibody was passively acquired. I am thinking of going to ISXM's of unscreened units for the RhIg patients. Thanks for your input.

Do you provide CDE neg units for all patients that have anti-D and anti-D due to RhIg? We do AHG xms only for the "true D's" and use IS xm's for the RhIg patients. But, for both we always give C and E neg units too (we need to rule out on one homozygous cell and you cannot rule out C or E that way with someone who has anti-D). I am contemplating going to IS xm's with no antigen screening required for the OB patients with RhIg. Any thoughts on this?

To all gel users: do you feel it is critical to have the "air gap" in between the cells suspension and the gel media? Some of my techs have been trained that way and are insisting that they see weaker reactions with the QC (expected 2-3+ but only see a w+) if there is no air gap. The directions for the gel cards state " the mixture may or may not touch gel suspension". I have already contacted tech support at Ortho and they are supporting the directions as written and MTS in Florida is also stating that it does not affect testing. What do you think? Do you start over if you see the suspension has gone beyond the "reaction chamber" prior to incubation? Thanks! Barb G.

We also keep the rbc syringes (using a SCD) for 24 hours and the platelets for 4 as the syringe manufacturer suggests. However, it is rare for the rbc syringe to sit for that long as we prepare them as needed. Most are used within several hours. Not sure about that AABB reference regarding an "unlicensed product". I would think that as long as you are not transferring to another facility it is a non-issue. Good luck!