natalynn

How very scary for her. : / patients get worried when they hear they have an antibody I could only imagine this.... Galvania do you know if the warm sand would need to be validated? We would use it very very rarely but I like to have a plan in place if we do have a patient like this.

Do you know if any validation has to be done in order to put this into place for our very strong cold patients?

Is this acceptable to do prior to blood bank type and screen/crossmatch testing?

Dissolve 1 gram DTT into 32 ml PBS. Aliquot into 2 ml samples and store at -20ºC or below. Expiration is 1 year from preparation. http://www.sigmaaldrich.com/catalog/product/sial/d0632?lang=en&region=US ^ you can buy it pre packaged in 1g amounts. (the price has gone up! ha supply and demand I guess)

Thanks guys, I let this thought go... we wont dont it. Instead we'll warm up a bottle for use in prewarm procedure then toss it after.

Exlimey, Sorry to get back to you so late, but I don’t even know that you need my 2 cense now, everyone seemed to cover my thoughts already. Since (little) k is so rare it will not hurt to check for it on your patients and give (little) k negative units to the few (if any) that are negative for the antigen. We do a molecular genotype on our Darzalex patients before they receive their first treatment, so we have their K and k results in hand ready if need be.

If the patient is k negative based on genotype be sure to be giving k negative units! We only have 1 departmentalized blood banker at the moment and we have brought in DTT testing for these patients. Its MUCH more cost effective to do it in house rather than send out, and if the pt screen is negative well then IS or EXM (K negative or k negative depending on their genotype) is much cheaper than phenotypically matched products!

1/2 credit? for returning within a certain time? Or full on credit for all even expired? Thats pretty amazing!

Any reason why I could not leave a bottle of blood bank saline in a 37 degree incubator for the life of the saline so it is ready to go when needed for prewarm testing?

Hey Guys, We've been touched by the Darzalex in our blood bank... so we've adapted and brought in DTT to try and aid in this situation. But here's my question, if a patient has an actual antibody (say anti-E) and we identify it using DTT and then do an extended crossmatch with E and Kell(CD38 destroys the Kell antigen), the crossmatch is going to be incompatible. To avoid performing our least incompatible procedure where we need a deviation signed each time, and transfuse 50cc then perform a DAT we were hoping to get a standing deviation for all patients recieving any CD38 monoclonal drug. BUT im not sure if this is ok to do... does anyone else out there have a standing deviation for anything in there Blood Bank. And if so would you mind sharing how it looks and what all needs to be on it for it to be kosher.

Here's the scenario... We are a surgery hospital for the most part. Patients scheduled for surgery always have pre admission testing done a week or so before their surgery date. If I get an antibody I can’t identify I send it to our reference lab, they then identify and send us units for surgery. The patient comes back in their day of surgery and gets another Type and Cross done. I do the screen and to no surprise get the same positive reactions that I once again cannot identify with the tools I have in house. My question is do I have to send it out to reference lab again to get the same results back or can I say no identification necessary because the patient has not received any blood products since the last antibody ID, and the screening cells are the same as before? Thanks for your help!

Thanks guys! I appreciate the advice. Goodchild... no were the only ones in the area that is going to do antigen typing in gel everyone else does tube.

Also since this is IgG cards do we suspend the patien/donor red cells in Diluent 2 instead of Diluent 2 Plus?

I am working on a procedure for gel antigen typing with anti-kell antisera. It is an antisera where you add AHG... so then is it done in IgG cards? and the instructions for use says to incubate at 37 for 15 min so that would be followed in the cards as well, but I'm confused to the need of washing like you do with tube... obviously this cannot be done but will it cause an issue by obmiting this process? And since we are going away from the instructions for use, am I correct in saying a validation must be done? Well what if we do no tube testing where I work so I do not have means to compare these two methods, could I instead just test the gel method with heterozygous and negative pannel cells and document this as my validation? Any guidence would be appreciated.

This is perfect! Thanks so much, I'm dorking out a little with excitement!