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Sorry I missed this discussion, it was very interesting. Since an email sent out re-opened this discussion I would just make a brief comment. HDN is a terrible outcome for the child especially, and also the mother and family. Not using antenatal RhIg is medical negligence. Not giving a potential D negative female/mother RhIg is close behind. It has always been a challenge with our anti-D reagents to deal with interpretation of weak reactivity and females of "child-bearing" age. And our testing methods have improved over the years. However, with the advances in molecular biology is ser

I somewhat remember that early on with the LUI freeze elution there were some attempts to elute non-ABO antibody specificities. At that time some suggested an additional source of protein and/or a minimal "LISS" environment might help with detecting these other antibody specificities. I'm not sure it worked out too well and other elution methods were much better. We just used for ABO elutes.

What? No one questioned NISS? I am impressed. Long Live NISS!

Inspectors are like a box of chocolates, you never know what you are going to get. I tend to agree with those who put forth do what you are comfortable doing for validation and/or QC. If you, your staff and pathologists are ok with your process then an Inspector (AABB or CAP) can have an opinion but they cannot tell you to stop or defend a deficiency. If your documentation has merit then you have a strong case of how you use your expired red cells or antisera for the care of your patients. We all do the best we can with what we have to work with.

Wow this is a late post. I just can't find the time to keep up sometimes. I certainly was not implying that either Duffy antibody would not be able to cause HDN but rather theoretically speaking given the circumstances it didn't quite give the picture of HDN. Again, even that is not a absolute. Looking back at all the comments and possible causes, which all had merit, I failed to see any reference to the possibility of an autoimmune issue and that there may be a possibility that the specificities are part of an newly development of autoantibody complex forming, i.e. mimicking speci

Since this is a accreditation agency group I would like to get an opinion on the requirement of the transfusion service's requirement to re-type the donor units. I do not know if this has been previously studied or written about in the past. Just thinking outside the box... If a donor center were to re-type the unit after the unit had been labeled and the unit tagged as such for the re-typed would the transfusion service be required to re-type the unit? You can't make an argument that you do not trust the donor center since you do not repeat HIV or etc. testing, and those tests are

My initial answer would be no. Haven't seen this happen with a transfusion of 1 unit. Would have to recheck the whole process of the 1st sample (pre transfusion), starting from the collection (correct patient, correct collection site, correct person collecting, correct labeling, specimen handling, specimen testing, etc.etc)…. maybe there was an error along that path and not a immunohematological issue?

Anti-Fya and Anti-Fyb are not well known to cause significant HDFN. I have not seen one, at least. Was there any follow-up testing of the infant? What were the laboratory findings, i.e. bilirubin etc. ? It has been a few months now, have you had a chance to re-type the infant's red cells? Is there a chance that it really was a weak binding of Anti-Fya with Fya+ red cell antigens? If only a gel-card method of interpretation of a "weak positive" as being negative was used, I wouldn't necessarily be convinced that the infant is Fya-. Gel card methods do funny things sometimes.

"Does anybody know what time it is" Chicago, 1970. Does anybody know what titer it is? Simple question, answer not too simple. If you are following titers of a specific antibody for a specific reason (anti-D, pregnancy), it is important to establish the method you use is reproducible and that it correlates with what the physicians that are going to be using that information for. As has been pointed out with previous responses, the methods used for antibody enhancement may affect the endpoint results of the antibody titration. The physician is often attempting to make a decisi

I know this is a late response but re-reading some posts brings up old ponderings. I have always been interested in the non-immune stimulated antibody specificities (naturally occurring). When we have seen these in different patient populations, i.e. malignancies, pregnancies, and autoimmune anemias. There was some papers that put forth the term "mimicking" antibody specificities, we may occur from immune malignancies, drugs, herbs, etc., or due to a dilutional effect or specific enhancement methods. At the time we attempted to absorb and elute the antibody specificity in question with

I certainly agree with Mr. Blumberg and Mr. Needs as well as others, everyone brings up excellent points and explanations. My only comment I could put forth for consideration would be from a BB Pathologist I once worked with many years ago having observed similar cases. "Pregnancy is a disease".

I am interested if anyone has attempted to use one of the wireless temperature monitoring systems to monitor the coolers being used within the hospital? More hospital in the USA are looking at these systems for their refrigerator/freezer/room temperatures monitoring. That would seem to be an excellent monitoring and data documentation for the products outside BB's control.

It is all relative. Yes, antibodies' titers can rise and fall during pregancy whether or not the fetus is positive for the corresponding antigen(s). So titers may not be helpful in a subsequent pregnancy from a mother whom has shown to be an immune responder. But, it may be a one piece of the puzzle a physician can use to make decisions about the management of the pregnancy. It may be an opportunity for us to be part of the team, share our knowledge and experiences with the team, follow the immunohematology path, maybe learn something ourselves and share with our peers. I would be willin

WOW, don't see anti-JK3 too often! Have you already pursued family members and extended family members? Also, is there a ethnic group you may want to screen? We have had some success in the past in our area with Native Americans whom have had some members with a antibodies to a high antigens. Certainly would want that patient and or other family members start donating and freezing their donations for their and others' future. Technically, I agree with Mr. Needs approach with trying to resolve your immediate requirements. Good luck and best wishes for your patient's recov

I would be interested in the patient's history; male/female/ pregnancy/infections/drugs/drug use/medications/herb etc. use/transplants. Also, specimen information; standard clot tube/clot activator? / edta or other anticoagulant, time from collection to testing/ storage time? etc. Have new specimens been collected and retested by same and different methods or lot #s. I apologize in advance if this is asking for basic "given" items that were all ready looked at but before I would investigate unusual laboratory findings I am always interested in history first before finding out there we