Veejay

What ethnic descent is the patient. Could the antibody be anti-U?

What is the Fya and S phenotyping for the 3 cell screen? Test some more Fya neg, S neg RBCs as the enzyme panel was non reactive but IAT did react, also the cell tested that matches the patient's phenotype is reacting so something else is there too. Maybe it is anti-Fya+/- Anti-S + something else? Send to red cell reference lab.

There is an article on this topic published in Immunohematology 2005; 21:94-96 by John Judd et al "On a much higher incidence of anti-c in R1R1 patients with anti-E".

I'd prefer that RhIg be issued by the Transfusion laboratory so that it is tracked in the Blood Bank's computer. It is an important blood product that the lab staff need to know about, its not an insignificant antibody.

I'd follow strictly what the manufacturer recommends. Wash solution is cheap compared to having to repeat all your work when you get grotty reactions.

Wow that is sad news. He was extremely knowledgable but was gifted at explaining things to us lesser mortals. Do we know what caused is death?

1. Albumin - Blood Bank 2. Clotting Factor concentrates - Blood Bank 3. Rh Immune Globulin-intramuscular - Blood Bank so we can trace who has Rh prophyaxis 4. Rh Immune Globulin-intravenous (WinRho) - Blood Bank 5. IVIg - Blood Bank Only product shared with Pharmacy is NovoSeven. Blood Bank keeps the bulk but Pharmacy has some too.

DAT is run if EDTA specimen shows haemolysis. Panel run by BioVue glass bead IAT and if all cells pos we run DAT to exclude / include auto Ab.

We use Ortho Clinical Diagnostics AutoVue Innova.

I know we do re-type units for ABD from a segment integrally attached to the donor unit by way of a group check card on an analyser but have often wondered why we do this. Our blood is sourced from a licensed facility so why can't we "trust" their grouping if we trust their HIV, Hep, VDRL, NAT and so on?

I disagree Malcolm. We use Q-Pulse 5 and it is extremely complicated. I get so many e-mails telling me such and such is due for review or to be authorised etc its as annoying as getting spam. I regularly have 30+ emails from Q-Pulse reminding me of silly things like the folder spine names need their annual review or the title page of a method needs reviewing that it gets in the way of actual work. The system of checking out and checking in documents and whether they are in draft mode or active mode is needlessly complex.

I agree it is very good. It saved me heaps of time too as I also was going to make something similar.

I'll contribute a little to this discussion too if I may. For ABO reverse grouping the column tests rely on haemagglutination already occurring in the upper part of the microtube. The Ag-Ab bonding is just happening via Brownian motion. Then during centrifugation these agglutinates get trapped within the gel or glass bead matrix. In contrast, in a tube test the antibodies within the reverse grouping plasma / serum are physically forced to get close to the red cells and if the corresponding antigen is present the agglutination will occur. The technical challenge then is to shake the tube gently enough so as not to disrupt the agglutinates.

Yes. Follow the Manufacturer's instructions.