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snance last won the day on April 27

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  1. The Sandler reference is Sandler, et al Transfusion 2015;55:199-204. I see the Italian document recommends testing for IgA, At a routine hospital level of detection (5mg/dL) there will be some patients interpreted as IgA deficient and deferred from getting CCP by the Italian guidelines that do have detectable IgA by more sensitive testing. There is no mention of IgA testing in the WHO Interim Guidance document (Teo D et al) posted on the ISBT Website. The USA American Rare Donor Program (ARDP) uses a level of 0.05 mg/dL to define IgA deficiency for donors and patients. The ARDP has an algorith
  2. Has the presence of anti-Sda and anti-Lub been ruled out? Both have been reported to show mixed field reactivity and both can be reactive at room temperature. Microscopic exam of reactivity in any phase would help rule out anti-Sda, and since your said it did not look like rouleaux, can it be assumed that it also did not look like an anti-Sda? That leaves possible anti-Lub. The RBCs could be cleared of IgG and typed or an Lu(b-) RBC could be tested with serum and eluate. And, this could be an autoantibody...And then going back to a sample to blood bank for broken wrist, perhaps more going on
  3. If there is suspicion the patient was unknowingly transfused (has the patient been asked?), you could compare the genotype panel of peripheral blood and the phenotype (and look for mixed field in other typings)
  4. I offer the following based on experience with the MMA and antibodies to antigens of high prevalence and should not be taken as clinical recommendations. The National Reference Laboratory for Blood Group Serology for the American Red Cross has performed Monocyte Monolayer Assays (MMAs) in over 200 cases of patients with anti-Yta in order to determine which patients have antibodies of potential clinical significance. The MMA has been performed for more than 30 years. The reason to perform the MMA is to conserve the supply of Yt(a-) units for patients who have had either had decreased survi
  5. In the USA, all AABB accredited IRLs (Immunohematology Reference Laboraotories) and American Red Cross IRLs are members of the American Rare Donor Program (ARDP). This program has over 45,000 Rare Donors registered from over 88 member centers. If your blood supplier is not a member of the ARDP, your facility can access the program by sending a sample for evaluation to a member. If there are no member centers in your area, the Penn-Jersey American Red Cross can be a "portal" to the ARDP. After a sample is submitted and tested, Penn-Jersey will access the ARDP for the non-member hospital or blo
  6. The Monocyte Monolayer Assay has been used successfully for over 30 years in the USA to predict the outcome of incompatible transfusion in the face of an antibody to a high prevalence antigen. These results have been extremely useful in the stewardsip of the Rare Blood Supply since a negative result means that the patient can be transfused random products for that tranfusion. If the patient is transfused, another MMA must be performed before another random transfusion can be given and be performed as close to the time of the next transfusion as possible. This assay is performed in the National
  7. Very cute, started the morning off with a smile! Merry Christmas
  8. While a useful method for antibody detection, it is controversial whether the Gel method is superior to tube methods in the investigation and identification of red cell antibodies. The American Red Cross has 40 IRL locations across the USA. With that number of IRLs, there are thousands of hospital and other blood center customers with different methodologies that refer samples to the ARC. The IRLs choose methods that are best suited to the majority of their local customers and methods that are able to detect clinically relevant antibodies as required by AABB Standards. Facilities with Gel as t
  9. The American Red Cross in Philadelphia has performed QC for Fibrinogen and Factor VIII levels on American Red Cross and non-Red Cross Cryoprecipitated-AHF products for over 20 years. If you wish to investigate sending your Cryo for QC to the American Red Cross, please contact Cynthia Flickinger at 215 451 4909.
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