Kwenz

We have had problems with random lots of the Ortho 0.8% screening cells for a long time. Hazy, junky reactions that are negative in tubes with PeG. Have you recently changed cell lots?

It scares me when I think about how often I've heard the "just give me O Negs" out of a doc's mouth when they don't want to wait for screened units. If someone ever does come up with a way to strip off all those antigens, they will be very wealthy. On a lighter note, back in my chem days we were having a problem with a 24 hour urine collection. It came down 3 times, all significantly less than a 24 hour collection. When we talked to the doc, he said with a totally straight face "The patient can't hold it for 24 hours."

We have always treated an auto unit and the associated patient sample the same as any other patient and unit. There is always the possibility of a labeling error.

When you are phenotyping DONOR UNITS, do you do a DAT on all positive results to prove that the result is due to the presence of antigen on the cell and not because the unit has a positive DAT? I understand the need for this on a patient but question the need to do it on a donor unit.

We have also seen non-specifc reactions. Our last lot screen cell 2 gave us fits. All patients were negative with Ortho panels (A&, negative with panels using tubes with PeG. I had hoped it was only that lot but it happened again today. When I last called tech services, they said no one else had any problems. At least know I know we're not alone. I'll also echo the problem with colds showing up (esp those homo only Ms) They cause a lot of problems as all of our techs are generalists and don't always think to look for that homo only reaction pattern. I would say that the new formulation is no better than the old.

How do you obtain the sample to culture a blood bag after a transfusion reaction? Do you enter via the unused port, stick a needle right into the bag or do you have a better technique. Also, do you culture from the tubing in addition to from the bag and do you culture the saline bag that comes down with the unit? Do you just add to broth and then subculture or do you acutally set up blood culture bottles? If you have almost no sample to work with, how do you prioritze? We have 6 hospitals in our system and it seems that we all do it differently.

We also use A,B only for bag typings.

THis issue has come up within our network. Our FDA inspector has never questioned the 24 hour expiration date. Has anyone received a definite answer on this? I find it hard to believe that virtually everyone in the country has been using 24 hours in violation of FDA rules.

We just finished a CAP inspection. I had a disagreement with the inspector about alarm settings on my platelet incubator. It was set to alarm at 20 and 24 degrees. She said that was unacceptable, that I needed to have the alarms sound at 20.1 and 23.9 because if the temp hit 24 I would have to discard all the platelets. Needless to say she won but I still disagree. If AABB says the storage range is 20-24 degrees why would you have to throw out platelets if the temp hits 24? What temps do others have their alarms set at?