mpmiola

I would like to know the behaviors that have been adopted in your service in cases of bone marrow transplantation from RhD + patient, RhD- donor for transfusion of platelet concentrate. Is there a concern to provide RhD- since the infusion? Or after the patient only presents donor phenotyping RhD-? In the impossibility of providing RhD-, have hemotherapists indicated anti-D prophylaxis?

We understand what happened. We received the patient 12 hours before this transfusion. Despite having denied previous transfusions, we contacted the health service of origin who informed us that he had transfused platelets in pool (600 ML) the group O. Therefore, we believe that the reaction after red blood cell transfusion was a coincidence, and the anti-B of the transfused platelets must be the cause of hemolysis.

We didn't have B- in stock

We performed the tests with serum, everything negative. The most likely suspicion is passive anti-B

Thank you Malcolm, we do not test with serum, I will do the tests now

Hello, I need help to understand this Acute Transfusional Hemolytic Reaction. A patient under investigation for acute promyelocytic leukemia, after transfusion of red blood cells in group O, presented fever (38.6 ° C). Immunohematological results of the patient: - pre-transfusion: B negative, negative irregular antibody test, negative DAT, negative compatibility test - post-transfusion: negative B, negative IAT, positive DAT 2+ (C3d only), negative compatibility test, negative eluate, negative anti-B test with eluate serum Laboratory results: - evidence of hemolysis: DA

I do not agree with the transfusion prescribed at pre-defined frequencies, such as 4/4, 6/6, 8/8 and 12/12 hours. We are trying to change this here, but we find resistance. How is it in your service?

I'm very afraid of this happening here.

That's exactly the card.

Thank you all for the answers. Unfortunately, some places here in Brazil employ nursing technicians to work in a blood bank.

Sorry Malcolm, I did not get it. Is it better to have nothing than to leave them to do? Or simply is a bad option!

We have already thought about releasing red blood cells from group O until a confirmation, but it was not well accepted at the time. Do you have problems with stock due to red blood cell release "O" until confirmation? How do you do for underweight children? Do you wash the red blood cells to remove antibodies?

Yes, in Brazil too, but not for an additional test at the bedside. Either way, training is needed also.

Our transfusion team is composed of nurses. Pre-transfusion tests are performed at the transfusion agency. This bedside test would be a confirmatory one. In the proposal we received from a company, they claim that the tests are easy to perform and the card should be returned to the transfusion agency for registration. We do not currently have a confirmatory test and we release identical ABO transfusion without a second sample. That scares me. It's a time bomb.

Thank you R1R2 and AMcCord by the contribution