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dwalters

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  1. I'm wondering if the most common current practice is to crossmatch red blood cell units with the adsorbed plasma or do most facilities just issue antigen negative units without crossmatching them first with adsorbed plasma. (Either way, documented as least incompatible.)
  2. No, Immucor doesn't offer 0.8% cells. If they did, we would use them for our panel cells also. Ortho states in their package insert that E and K might not be detected rarely, however, I've seen this also with Jka.
  3. An ER trauma patient's plasma showed 1+ reactivity in Gel with Screening cell 1 of Immucor's Trio screen. The other two cells were negative. (We buy 3% Immucor screening cells, then dilute them to 0.8% for gel testing.) Using an Ortho 0.8% panel for antibody identification, we found 7 of the 11 cells reacting 1+ with a negative auto control. The reactions did not fit any pattern what-so-ever. Our workup was stopped at that point because the patient was transferred to a larger facility. On follow-up the next day, we found that the other facility had gotten a negative antibody screen, also using Gel cards. Within three hours of performing the antibody screen on the ER trauma patient, the remaining three wells of the gel card were used to perform an antibody screen on another patient. So, the card with the positive Screening cell 1 was spun for another 10 minutes. After the 2nd spin, the reaction had changed to negative. Later, we spun the two cards containing the antibody id with the seven 1+ positive reactions. After the 2nd spin (for a total of 20 minutes) most of the reactions were now negative with the others only questionable, definately not 1+ as after the orginal spin. I've checked the rpms and timer on the centrifuge, and they are okay. Has anyone else seen positive reactions change to negative after spinning a second time?
  4. During the last two months, I've had three specimens containing anti-D which reacted 1-2+ with some C+ panel cells, most recently, a CAP Elution survey. The other two specimens were from an OB patient who's plasma contains anti-D and anti-E (the patient is rr). Antibodies to all other commonly occuring antigens were ruled-out. The samples were collected one month apart for titers. On the first specimen, 2 of 9 selected panel cells which were D=E=C+ reacted 1-2+, the other 7 were negative. I used both 0.8% Ortho cells and 3% Immucor/Gamma which I diluted to 0.8%. There was one panel cell expressing homozygosity and 6 panel cells expressing heterozygosity that gave negative results. Of the two reactive cells, one was Ortho and the other Immucor/Gamma. Both were expressing heterozygosity. The other two samples reacted simularily. Any thoughts?
  5. About 20% of our platelets stocked for CABG procedures are wasted annually. Only approximately 38% are used for CABG patients, but the other 42% gets used by oncology patients. We are required to stock 2 APLTs for each CABG, and we have one physician who occasionally orders 4 APLTs on hold.
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