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YorkshireExile

Repeat antibody investigations

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What do people use as the criteria for when to repeat antibody investigations?

If the previous sample was only three days old, and the new antibody screen was positive with the same strength reactions as the three day old one, would you do a full antibody workup again?

What if the previous sample was seven days old or even one month old? When would you repeat the full antibody workup?

if the patient has been recently transfused or is pregnant would that affect when you repeat your antibody work up?

Interested to hear what you all do.....

 

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If the patient has been transfused or pregnant in the last 3 mos, one has to r/i r/o significant atypical antibodies every three days.  This going to involve more than a screen.

Scott

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our facility draws presurgical type and antibody screens, if that sample has a positive screen we send it to our ref lab(ARC) for antibody id, when same patient presents for surgery(may be  two weeks usually could be slightly longer) we repeat type and screen which will be positive BUT we don't send that sample for antibody workup as long as patient is not pregnant and has not rcvd transfusion since presurgical testing. we add canned comment to the day of surgery positive screen stating "Antibody previously identified. Patient is not pregnant and has not rcvd a transfusion since the last antibody screen and identification on dd/mm/yyyy.

since we know which antibodies pt has from presurgical, we have ag neg units delivered a few days before surgery and do a full xmatch with surgical sample in which patient is banded.

 

We send all ob/gyn patients with positive antibody screens for full work-up, usually once per pregnancy, but may need to do titers throughout. even rhig patients giving date of injection to ref lab.

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19 hours ago, YorkshireExile said:

And if not pregnant or not transfused within the last 3 months?

 

That caveat is used for inpatients who have a continuous stay.  We cannot take the patient's word for it if they have been away from our facility.

However, we have an exception for pre-admit testing, which we will allow up to 10 days before the procedure IF the patient gives us info regarding pregnancy, transfusions and other hospital stays. 

Also, in a similar vein, we generally will not repeat an eluate on a positive DAT if it has been worked up recently and the strength has not changed.

Scott

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On ‎4‎/‎17‎/‎2019 at 8:21 AM, SMILLER said:

That caveat is used for inpatients who have a continuous stay.  We cannot take the patient's word for it if they have been away from our facility.

However, we have an exception for pre-admit testing, which we will allow up to 10 days before the procedure IF the patient gives us info regarding pregnancy, transfusions and other hospital stays. 

Also, in a similar vein, we generally will not repeat an eluate on a positive DAT if it has been worked up recently and the strength has not changed.

Scott

Exactly Scott, we have many patients who are "snowbirds", spending the warmer months here in New England, the head down south for the winter. We have no idea of their transfusion history away from here, and often are not very reliable upon questioning as to where / when they were transfused. Other local patients seem to like trying out different hospitals (we have about 5 within 30 minutes of each other). We sometimes call them "shoppers".

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On 4/19/2019 at 1:56 AM, YorkshireExile said:

Smiller -  When you say you have done a "recent"  pos DAT workup, how do you define recent? What time frame?

Generally during the same patient stay.  

Scott

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