AuntiS

My question would be - how strong was the pre-transfusion reactivity? If it was only 1-2+ in SP / and the patient isn't a "larger" person, I personally would suspect that the antibody titer was diluted to such a degree that SP did not pick it up anymore....... (but I REALLY don't like SP.....it's just too wishy-washy.....JMHO)

I agree Darin, it is almost certainly a dilutional effect, BUT, it could also be the effect of a soluble antigen (obviously not within the Duffy Blood Group System). If the antibody had a specificity within, for example, the Lewis Blood Group System, or the Chido/Rodgers Blood Group System, the antigen in the plasma could well adsorb out the circulating antibody. That having been said, this explanation is FAR less likely than your suggestion of the dilutional effect.

We did a Plasma Exchange recently on a patient 5 days in a row with approximately 10-12 units of FFP each time.
On day 3, the band expired and we retested the new sample to find the previous antibody had disappeared.
It's a dilutional effect where the titer is dropped below detectable levels.

Your policy (to draw and test your own specimen) is the strictest interpretation of the standards (and one that most blood banks likely follow), but I do believe you'll find systems that share MRNs, share LIS, share policy & procedure (may even share technical staff) that will use pretransfusion results performed in blood bank A to transfuse the patient at location B by technical staff in blood bank B and are doing so within AABB and CAP standards.
All that is to say, I don't think you'll find a standard that explicitly says you have to draw and test your own specimen at your own physical location. We come to that conclusion because of all the other standards.

In my opinion, if you have:
A cold antibody (not pathological), and
Have done the workup to show that there is no other antibody present (i.e. a clinically significant antibody such as anti-E), and
Your LIS dictionary set up so that your reported antibody is not deemed as clinically significant
You can set it up so that the computer (electronic) crossmatch can be used.
If it is a pathological antibody, we use incompatible (i.e. Least incompatible in Meditech)

Yes, we needed to reduce the expiration to 28 days from the date of collection.
We issued about 100 units of RBCs a day, we didn't outdate a lot.
We had a huge cancer population, we just felt it was safer to irradiate everything.  We also adopted 100% leukoreduction much earlier than most facilities.

The +s stands for strongly expressed.

The expression of the P1 antigen varies considerably from person to person, but the reaction strength with anti-P1 is an inherited trait (i.e. the strength of the expression on the red cell surface).

"I apologize for this dumb question."  BBnoob69, NO QUESTION IS A DUMB QUESTION, IF YOU DO NOT KNOW THE ANSWER.  If you don't know the answer, the dumb thing is to not ask the question in the first place.  NEVER be afraid to ask a question on here,

Our hospital prefers to use the term birth parent instead of mom/mother.
I've been making a conscious decision to try and use the more inclusive terminology

Haha no.  But it fits!

Did you mean that AuntiS.  I fully confess there were times when I did!!!!!!!!!!!!!!!!!!!!!!!!!!!

We do that.  You could also use LISS (or PEG) to complement your SIAT.  Make it more sensitive. sandra

We do that.  You could also use LISS (or PEG) to complement your SIAT.  Make it more sensitive. sandra

We do that.  You could also use LISS (or PEG) to complement your SIAT.  Make it more sensitive. sandra

Switch back to the patient's own ABO type as soon as possible is my advice.  For everything.  RBC, platelets, cryo, plasma.  Worrying about the anti-A and anti-B in low titer whole blood is relevant, but so is the smaller amount of incompatible plasma in group O red cells, which are not low titer. There are rare reports of severe hemolytic reactions to group O red cells in non-O patients. Furthermore, the patient is continually making their own group A, B or AB red cells, so hesitancy about transfusing their own ABO type is not helping things get better.  By giving additional group O products we are making the problem worse, not adding safety in any way.
Furthermore, the non-O patient's endothelial cells, platelets, von Willebrand factor, hepatocytes, etc. are all incompatible with the transfused group O plasma, and their function is impaired when modeled in vitro, and leads to increased bleeding. 
Thus there is no benefit whatever in giving group O red cells (or whole blood for that matter) to non-O patients once the hemorrhagic problem is largely under control. And there is likely added risk.   It is only adding harm and reducing the inventory of group O blood for group O recipients.  A total mistake of the last few decades in my opinion. Giving group O plasma containing products to non-Os is only reasonable when you don't know the patient's blood group, or don't have their blood group in stock, or it's an emergency with no time for giving type specific.
No one ever went broke overestimating the importance of the ABO blood group in transfusion.  See attached for the literature references.
ABO trauma commentary Frontiers bioengineering.pdf Reconsider ABO compatible:universal donor.pdf ABO ARC MAC copy.ppt

It is standard 5.1.2.4: The laboratory shall evaluate the comparability of test results obtained using different methods, instruments and if applicable testing sites. This shall be performed twice annually.
  We use old CAP samples or known patient samples with antibodies. Test them on the analyzer and with PEG on the bench. 

This is a good solution, I would like to suggest that you do not retest them until after the due date, not just the date you reported them.

We use our "old" CAP samples...........
Once they've been turned in and reported, we assign them to techs using our "other" methods.
SOP is gel/Ortho Vision Max
Additional testing then would be manual gel, Peg, LISS, Saline.
Same for titers and DAT's
Seems to work pretty well for us!

This is a great book :)

For serological testing or for clinical situations?

I'm trying to get rid of this practice as well (ours is called "keep on hand").  I think it is completely unnecessary.  If there is no antibody = electronic crossmatch and blood is ready immediately.  If the sample is more complicated, we already make sure we have blood crossmatched so there is no delay.  Slowly but surely....

We use the electronic crossmatch when the antibody screen is negative and there is no history of antibodies. 
We also use this in lieu of the IS phase when we perform an antiglobulin crossmatch. Our AHG XM's are performed on the Vision with the IgG card.

I really enjoyed this talk!

I really enjoyed this talk!

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Cerner allows us to extend the date of the Preassess sample. If no pregnancy or transfusions, and a prior history or second sample drawn for confirmation of ABO/Rh, sample good for 4 days with OR day being day one. Not to surpass 30 days sample date. EXM still applies when sample date is extended.