exlimey

See....you've already got the makings of a club. You can celebrate your CEce heterozygosity together.

Good point, but we're very unlikely to make the antibody.

Sorry, John. You'll have to start your own club. Perhaps "f-negatives Rule", or something like that.

An interesting idea, but I'm not sure I want my psychological dirty laundry hung out for the world to see.

I confess: I'm much the same way in the OCD sense. I'm also DCeDCe (R1R1), so perhaps this issue hits a little too close to the sensitive area.

An EXCELLENT question, John, but as Malcolm suggests, is appears that there is still a large dose of "we always do that" in many laboratories.

Short answer: Yes How was the anti-Jka detected initially, i.e., what technique ? Assuming it was an antiglobulin test, but was it Gel, Solid Phase, LISS, PEG ? Yes, the panel cells are now ficin-treated and antibodies to Jka should be enhanced, but the test conditions that were used in the original assay may not exist when ficin-treated cells are used - one may need to add LISS or PEG, one may need to test by Gel or Solid Phase.

Ouch !

Actually, I'm not suggesting that replacement of the batteries is cause to re-qualify a timer. Accuracy of most timers is not affected by battery replacement because there is no actual CALIBRATION, i.e., no adjustment process. Typically, today's timers are CERTIFIED - their accuracy is verified against a standard. That accuracy is independent of the batteries. But, I do agree that a broken/unreadable timer is the ultimate expression of "inaccurate".

Perhaps the real question is: Do you (or the supplier/certifier) actually CALIBRATE them ? That is, can the reading be adjusted in any way ? If the timer differs greatly from the "Standard", can it be tweaked into range ? Most simple electronic (battery-powered) timers are not adjustable. I'm not even sure that the official certifiers (the ones providing the certificates) are able to adjust the cheap and cheerful electronic timers. The electronics are so reliable (and cheap) these days that it's rare to find an inaccurate timer. The ones with unacceptable performance are probably just discarde

Tests on the adsorbed serum (with ZZAP-treated cells) give confidence that the are no underlying alloantibodies to common antigens. However, the use of allogeneic cells risks removal of a cold-reactive alloantibody to a high incidence antigen, e.g. anti-Vel, -PP1pK. A low risk, but still concerning. Does you facility also test the ZZAP-treated patient cells (now presumably DAT-negative) back against the patient's own serum ? This is ultimate proof that the cold-reactive antibody is an AUTOantibody and adds more confidence in the results of the adsorption with allogenic cells. I may b

Arguably the initial ABO discrepancy is proof of the presence of a cold-reactive antibody. If the DAT was positive, how do you determine that the autocontrol is valid ? Surely its just the same DAT-positive cells reacting with the antiglobulin reagent, or were the patient's cells treated to render them DAT-negative prior to testing ? Were the "zzap'd cells" autologous ?

Especially if the beast in question is largely IgM.

That's an excellent point. It always struck me as slightly odd that such critical testing is done by "drops" - a potentially highly variable volume. One certainly wouldn't see an HIV test kit give instructions like "Dispense two drops". Goes to show that the standard serological (tube) test is extremely tolerant of variation.

Wow. I perfectly understand the science, but that is an awful thing to put in a Directions for Use. A savvy Inspector could throw serious doubt on any tests performed using the supplied dropper. And why provide a dropper if it isn't good enough for the test ? The only way to meet this requirement to the fullest is to use a calibrated semiautomatic pipette.