bj5826023

To those who work in a reference lab, would you please help me with the questions below: 1. How many Ref techs are working in your lab? 2. Are you performing anything else other than Ref work? Please list additional (donor testing/processing, billing, distributing, hematology, bacterial detection, pH...etc.; student training) 3. What is your TAT for a reference workup? 4. What is your TAT for reporting your final report? 5. What is your volume like, approximately? 6. Is your lab completely separated from donor lab (component and distribution)? Or right next to it? 7. What are the business hours for your Ref lab? 8. Who does Reference training at your lab? How long is your training typically? 9. Do you have MT(4-year degree) techs or MLT (2-year) techs at your facility? 10. What are your most challenges as far as quality and customer satisfaction?

Very educational. Thanks for the post ginaL!!!!

Thank you Malcolm for all the helpful information!!!!! This is such a rare antibody. I wonder how many people actually have seen it.

Was this the first time the antibody screen is positive? If it's not and the antibody was identified before, it'd sound less "severe" and reporting is questionable, especially in case of emergency and if you don't know if it needs to be reported. Also, I don't see why it's such an issue, especially when you're only dealing with a very small volume of residual plasma. Worst case we've seen w/transfusion is having a positive DAT.

Thanks Malcolm, It's good to know that you have some frozen cells:) More questions though, was the antibody reacting w/all cells at IS, papain and untreated cells. Was your typing result the clue? Did you have other clues before the phenotype/genotype? I've never seen it and books I read didn't say much.

Has anyone seen how anti-Ena looks on a panel, other than IgM reactivity and when you type for M and N, since it's missing GPA?

It was both. We gave her RH negative units while investigating though.

Weak D type 4/4.3. Thought about doing an eluate anyways, even though DAT and AC were negative but then somehow got off track. Wouldn't WAA still react with cord D- cells? It was actually negative.

The report we got was weak D type 4/4.3

We ran a ficin to see if it's actually auto antibody w/D specificity, but then did not think about treating auto cells as well. Reactions were stronger with D+ cells and slight weaker w/other cells in gel ficin.

I can't remember since I don't have the case. No, we did not treat auto cells. Didn't think about it.

We have a pregnant female african american patient with an apparent anti-D in her plasma (no Rhogam received). Her gel ficin strongly is positive with all cells. DAT is negative and autocontrol is also negative. We sent the sample out of partial D typing and learned that she can make allo-anti-D. We've ruled out LW (cord cells only reacted w/D+ cells) so what is it in the gel ficin? What would you do next?