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Clarest last won the day on July 9 2017

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About Clarest

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  • Birthday 10/21/1971

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  1. Thank you Malcolm and David for sharing your experience with me.
  2. I totally agree with exlimey for keeping LISS-IAT as a backup and less sensitive method to the more sensitive ones like solid phase and others. Since the LISS-IAT is our backup method, we usually use it after the first solid phase panel combined with a tube DAT as no autocontrol is set up with the solid phase panel. Now, we are having a debate on whether we need to follow the statement on the Gamma N-HANCE package insert "An autologous control ... is recommended for compatibility and antibody identification tests." I was thinking that if the DAT has already been done on the same specime
  3. Hi Malcolm Needs, I would like to see an explanation for “why” on the package insert. Unfortunately, no! It only mentions an optical aid may be used. I am afraid of over reading by the staff. Particularly, we are planning to use this enhancement medium in our IAT corssmatch. Currently, we use saline IAT crossamtch. By the way, how would you define a microscopically positive reaction. How many cells clumping together would be a positivity. I find some staff even call occasionally seen “kissing cells” a positive reaction.
  4. Hi Kathyang, When you use either ImmuAdd or Gamma N-Hance, do you do the microscopic check for the negative reaction at AHG phase?
  5. Hi, our lab has the same situation as yours. I am wondering if you do the microscopic check for the negative reaction at AHG phase when using LISS enhancement. On the ImmAdd package insert, it doesn't mention the use of an optical aid, but the N-HANCE one does. Thank you in advance for your response.
  6. Our PreAdmit patient samples are valid for 30 days after collection if patients have not been pregnant or transfused in the last 3 months. We usually perform the group and screen test on the day of collection and if applicable, antibody workup ASAP. If required, we usually do the crossmatch one the day before the scheduled surgery date. Previously, we had separated plasma from cells for all samples. After we did validation to show that the reactions strength of ABO antibodies in the unseparated samples on their 30th days is comparable to that in the separated plasma, we stopped separating plas
  7. Below is the source of my 1st question. " If the patient has been transfused within the past three months, but not within the last three weeks, an elution may be omitted if all of the following apply: a). The DAT was positive on the last specimen tested (i.e. collected more than three weeks ago) and was investigated, and b). The positive DAT (i.e. strength of the reaction) on the current specimen is not stronger than the DAT performed on the last specimen, and c). The antibody screen (i.e. strength of the reaction) on the current specimen is the same as on the last sp
  8. Hi Malcolm, Look at what I found in the link below http://www.transfusion.ca/Resources/CSTM-Blog/January-2017/I-will-remember-you-Malcolm-Needs Clarest
  9. Hi Malcolm, 1. I agree with you if we suspect there is a transfusion reaction which causes the positive DAT with IgG, it makes sense to do an elution on the new sample in case some other antibody(ies) are being detected this time but not from the previous sample. 2. Even we test an eluate once every month for the patient with an autoantibody, it is exactly as what you said the eluate shows pan- agglutination. Unfortunately, we do not perform alloadsorption on site. So, the eluate really does not mean that much for detecting underlying alloantibody(ies) developed due to transfusion re
  10. We do exactly the same as Laurie said. I would like to take this opportunity to do another survey related to elution studies. 1. After a patient was transfused a couple of days or a week ago, we received a sample and did elution on it due to positive DAT with IgG. Then, several days later (no transfusion after the last elution) , another sample was received and the DAT was still positive with IgG. Do you do another elution as the patient has been transfused in the last 3 months? 2. If a patient has an autoantibody ( DAT is always positive with IgG) and has been frequently tra
  11. As Malcolm mentioned " as the anti-B in those units tend to be of lower titre and avidity than does the anti-A in either group B or O units". The patient is group AB and the red blood cells have A and B antigens.
  12. Hi Mabel, We use the tube saline IAT method for crossmatch and it is allowed to skip the immediate-spin phase. So, as long as the anti-A1 does not react at 37C, we have no problem to result the compatibility of the crossmatch. Routinely, it is okay for us to give group O or B blood for patient's with anti-A1 and that's what technologists prefer to do as it only requires immediate spin. However, for this particular patient, we just wanted to be more careful. Clarest
  13. Hi tkakin, You're right that anti-A1 typically reacts at immediate spin and that's reason for us to give group A or AB IAT crossmatch compatible red cells. On the other hand, if the group A or AB units are IAT crossmatch compatible with patient's plasma, it proves the anti-A1 does not react at 37C. Clarest
  14. Hi Malcolm, We gave group A IAT crossmatch at first when group AB was not available in our stock. Then, we particularly ordered group AB units to hold for this patient. I am really interested in the paper you mentioned in your post regarding AB antibodies. When you have time, could you please share it with us? Thanks a lot. Clarest
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