Jyoung

Platelet crossmatch with Gel! Just a thought. Not sure how it could be done, but how nice it would be if it could!

Thanks you guys for the references!

I had never heard of it either until after attending a SCAB conference a few months ago. Apparently you can add Combs AHG (IgG) to bind to the antibodies that are causing a positive DAT. This will then block those antibodies from reacting when phenotyping a patient through the AHG phase. How or why this doesn't block the antigen when phenotyping I do not know? But I was told it doesn't. I was also told this technique is mainly used for those patients with a strong postive DAT, where the DAT is still reacting after treatment with EGA. Thanks,

Does anyone perform what is called IgG Blocking on a patient with a strong +DAT? I just wanted to get some info on this and see if it is something worth trying or implementing. I think some IRLs in US may use this technique but not sure how well it is accepted and how well it works. Thanks,

I would question why your system let you issue blood on a patient with an antibody that was not cross matched through AHG phase. Our system (HCLL) sees anti-D as a level three antibody and would have never let us tagged the unit unless it was emergency issued.

We had same problem with last CAP survey. We actually ran the eluate with ortho's ficin (gel) and the 3 cell came up negative showing anti-e specificity. Then we ran the eluate with orthos A panel (gel) and showed anti-e specificity. I just thought that our C panel's 3 cell some how got contaminated, but after talking to friends at neighboring hospitals I found out that we were not the only ones that saw this problem.

I found in the package insert for the MTS Diluent 2. It lists Trimethoprim and Sulfamethoxazole as preservatives. These are antibiotics and maybe some patients build antibodies to these drugs. Not sure but seems like this is what was going on in my case.

I had the same problem with one of my patients also. I could wash cells with normal saline and all cells would be negative. Also ran anti-D as QC with washed cell and they reacted fine. I then took same cells and resuspended with dil 2 and the cells became positive again. We had already called this patient as positive in the past but never transfused them. I ran screen by peg. It was negative.

Cell 4 & cell 10 are positive for "V" on Ortho's VRC179 & I don't know about VS633.

Do you use gel method with all your different reagents or do you perform some tube? I would start with ruling out....... 1. Rouleax 2. Anti-A1 3. Cold 4. Anti-M: Run back type with Ficin. If it goes away probably anti-M. Then you can go from there. Lets us know what you find.. I'm curious.?

What method do you use for your antibody screen?

Oh I see. I missed the part that the K+k- cell is also D+. Sorry!

I would call it anti-K because if your patient is types as K neg it's not going to hurt to give K neg blood and most units are K neg. Have you tried running ficin to see if the hetero cells pop out?

All this input about anti-A1 is great. And I will definitely benefit from all of it if I ever see a patient with anti-A1 again. Since I'm one of those people that can't help but to ask why about everything. Im sorry, but I have another question..... When a patient that is A1 and is transfused with an O platelet that has a high anti-A1 titer wouldn't that prompt an acute intra and extra vascular transfusion reaction?

I missed it too! Sorry!