Everett9239

We do one cell from each panel daily. We rotate cells everyday, so essentially, each cell gets done about 3 times a month.

I feel as though the answer should be very cut and dry on this, but I am having a really hard time finding a source for this question. Can you run an autoadsorption on a pregnant person? I can find all of the documentation in the world about not doing this procedure on someone that is recently transfused, but the crowd goes quiet when it comes to the pregnant folks. Does anyone have a reference for this? Thank You!

This is something that I am looking to introduce in my lab. One of the things I was told in a recent inspection is that we cannot dilute the confidence antibody unless we are able to show that performs at or better than the standards put in place by the FDA. Furthermore, you must have some sort of test (a titer for example) to prove that the reagent has adequate reactivity before using it as a QC material. That being said, we were using a 1:11 dilution of the Ortho Confidence Antibody to run on our gel panels. I decided to start titering this to satisfy the requirement....but came up with a titer of 1 (naturally). So, I am going to work on perhaps diluting the confidence antibody x5 and seeing if I can come up with a weak antibody that way. Of course, then I will need to titer that each time I make it....ugh!!! It's always something...and I just got done fixing competency!

I do live audits, but it appears that we are doing quite a bit more than everyone here. Is there an established guideline, or a percentage of how many you should be doing to be statistically relevant? We struggle with getting enough audits performed, but I am wondering if there is a magic number?

We have many patients in our population that have warm autoantibodies. Most of the time, we try to get a phenotype on them, or have molecular genotypes done to provide phenomatched units. That being said, on the patient's that we are able to provide these type of units for, there is a question concerning how often they should have their warm auto 'worked up' to make sure there is nothing underneath? We are transfusing these patients, but in theory they should not be stimulated to make any other antibodies. I guess I just want to take a poll to see what the rest of the world is doing. Currently, we are using an every 30 day rule.

We are in the process of getting a new one, but we all know how long these transactions can take. In the meantime this is what we are currently dealing with.

If the patient is O Negative, we will start with O Negative and give up to 6 units (if available). After that, we will switch them to O Pos. If the patient is not O Negative, we will give O Negative until we get a solid type and can swith to group specific, or if our O Negative supply is running low, we will get a pathology deviation approval.

I have a question that we are having trouble wrapping our minds around. Our platelet incubator is getting too warm, so we have been using it with the door open. Because we are doing this, we have been taking the room temperature every four hours. Do we need to continue doing this? The platelet incubator chart recorder is still fully functional and the alarm is still functioning as well.

We have the Provue set up to not transmit the result when the D is 1+ or 2+. At that point we do it in tube to see if it is negative. If the tube is negative, we will report out negative. The Provue states that it can catch nearly all weak D, but what about partial D's? It was the thought of our pathology team that since partial D patients will present sometimes as weak D, it would be best to perform the test in tube and call it negative if it comes up negative in tube to be sure that the patient receives Rhogam. Albeit, literature does state that a partial D person has a minimal chance of producing anti-D to the parts that they do not possess, we have had 2 cases here thus far and they have really given the doctor's a headache. Hence the reason for this process. Since we do reference work, I must field the weak D question at least monthly. We seem to be having a lot of problems with discrepant results depending on the platform used to test the anti-D between us and other area reference labs. I have had to explain to many of them that our policy err's on the side of caution.

What is the difference between this test and a quantitative IgG or IgM. We are looking to discontinue this test at our laboratory as we only get 1 every 2-3 months, but I want to make sure there is an alternative available for the physician that truly wants it. At this time, we do not see transplant patients and do not do transplant surgeries.

This topic is coming to question at my hospital concerning Albumin. Since our albumin is a derivitive of human blood, should patients be required to sign a consent form for this as well. The risk manangement department is sighting the fact that certain religious groups are unable to accept products from humans, and therefore, would albumin not qualify as such?

We recently purchased a new double door refrigerator and I am writing the procedure for maintenance. For our older model double door, we must check the low and high alarm activation quarterly by manually activating the alarm (submerging the probe into ice water, and then into slowly warming water). My new double door has the capability of activating the alarms electronically with out the manual probe manipulation. Is this acceptable? Can I consider the electronic manipulation 'good enough' instead of having to do the manual manipulation?

I am currently dealing with the same issue. Technically whenever a patient presents with an antibody, we order two units on the patient to have available. We have decided not to do this for Anti-D due to rhogam. The problem is, when/if the patient does need units, our system requires the complete crossmatch. Does everyone just do immediate spin for Anti-D due to rhogam?

Does anyone give CMV negative to pregnant women? We have it in our policy, but our inventory is exclusively leukoreduced, so I am questioning the validity of this requirement.

I recently received my new Thermosafe coolers for validation for my MTP's. I was able to validate them for a max of 8 units for 6 hours (at 8 hours we started losing the temp). OR has decided to change the protocol and they want one cooler with RBC's and one with FFP. How can I validate the coolers for FFP? The temps tend to vary widely depending on whether you are using one that has sat in the refrigerator for a while or if it is fresh from the water bath. Do I need to re-validate with FFP or can I state that because it keeps the blood cold we can assume the FFP will maintain as well? I am so confused as to how to approach this. Thank You! Christy