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jojo808 last won the day on April 15 2021

jojo808 had the most liked content!

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  1. Let me start with an example: Oncology patient is admitted and has a critical WBC of 1.0 I'm going to assume everyone has to call the floors with this value. Now my real question is if the patient has a CBC Q6H how many of you have to keep calling the critical value. Is it not necessary in your hospital to call subsequent critical WBC values? Same for other critical values? Any other scenario can be used, and thank you in advance for any response.
  2. I understand now, had to read the thread over again and the reasoning with my simple mind. Well if the patient's antibody screen was negative prior to Darzalex treatment, then given K neg units once the antibody screen was affected by the DTT technique, then I can understand how giving 'regular' units once the antibody screen is negative would be acceptable because none of the units given would have caused that immune response (Aha moment). duh. Thanks everyone.
  3. I don't see the difference. Just because you give Kell neg units due to DTT denaturing Kell antigens, doesn't mean a Kell antibody was never there in that very sample. Is there any way you can prove that? Yeah I know I'm playing the devil's advocate, I really don't want to but if we are saying we can't rule it out, then you have to consider it may have been there right?
  4. I need clarification. I once asked on this site that if you could not rule out an antibody could you 'ignore' it once your screen is negative and I believe the answer was no. If in these cases with Patient's going off Daratumumab, if you could not rule out Kell (due to DTT treatment of cells), even once, don't you have to consider that a permanent problem even though we know that the probability that an allo anti-K developed is probably null?
  5. I think we need to add an OMG emoji to our selections!
  6. Some physicians are requesting that our IT build an Emergency release XM test to avoid having to sign 'the paper' for it. It will be a normal crossmatch test with the understanding that it is uncrossmatched and 'emergency released' via the verbiage that will be attached to it. Does anyone know if that is not acceptable to any agency? I will definitely require that the phone call to blood bank still be in the process, this is not my choice but I feel being forced upon us. I feel I'm the only one who objects to these things. Thanks in advance for the comments.
  7. When you say that the antigens are soluble and will inhibit the patient's anti-Lea in vivo, does that mean there will eventually be no Lea antigen on the donor rbc's? And let's just say it is certain that this patient has anti-Lea. Would there (theoretically) be no further problems with the first unit? or subsequent units?
  8. Fast forward: We think the cause of the incompatibility was (maybe) an Anti-Lea. We came to this conclusion because the 2 units that were clean were LeA negative and the other 2 that were reactive with the patient's plasma were LeA positive. This would be the only antigen that did not match the patient's phenotype. Anyway we are hoping our blood supplier can continue to get these (few) donors in. I think I've read in the past where anti-LeA is not clinically significant, but if this is an anti-LeA, it is not being detected by our ref lab who uses solid phase and tube. We use Ortho Gel (we do not have automation yet), soon to get the Biorad IH 500. Can't wait with all our antibodies!
  9. So we did perform the tried and true tube method with Peg enhancement (actually our secondary method) and both units came out a clean negative. The MD wanted to transfuse only one unit and see how the patient does. I'm so ok with doing that. I will try and keep you all posted thank you all again.
  10. I apologize for the delivery of my plea. The patient only has anti-Jk3, anti-E, and anti-c period. The others listed is what he tests negative for regarding his antigen typing. Thank for for the quick responses, we will have a discussion with our pathologist and the patient's MD and decide from there. Malcolm I know you are retired but your expertise is welcome each and every time. I'm just wondering how to result our crossmatches. I guess we can result the units as "least incompatible" (because they are) and enter a comment on this sample such as " Phenotype matched (or identical) rbc's given for transfusion" ?? With phenotype identical blood that is incompatible, would the results of the bioassays, (MMA, ADCC ,CLT, IgG subtypes) possibly show that maybe he has an antibody to a low frequency antigen? Gee how 'unlucky' can this person be? I guess anything is possible.
  11. Patient has the following antibodies: (Pt is B+) Jk3, E,c, He phenotypes K, Fya, S, N negative. Our ref lab found us 2 units that are phenotyped matched, one B+ and one O+ rbc. They are both incompatible, the O+ is 1+ in Gel, the B+ +/-. Auto control Neg, DAT neg (reference lab results). What's our next step??? BTW hope you all are doing well during this time.
  12. Forgive my ignorance but what is the positive reaction you get when testing reagent Anti-A with A2 cells due to??
  13. There is an article from George Garretty called Problems Associated With Passively Transfused Blood Group Alloantibodies that kind of mentions this. Although I feel it is perfectly safe to give out of group platelets, (we have done so for years) my concern was at what point would it interfere, if ever, with ABO/Rh type testing with tube method? According to the article worst case would be positive DAT but again I wonder if it would be detected in the plasma
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