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gagpinks

Immediate spin crossmatch

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Hi

Does anyone use immediate spin method for crossmatch?  Do you require any control in this process? I personally don't prefer this method especially when you have robust IT system and 2 sample policy. 

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We still use it for certain patients -- like those who produce atypical antibodies and need to have a AHG crossmatch.  

Scott

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We still use the IS crossmatch. (No electronic crossmatching here yet  :()

If the sample is not on the bench(we put it away) we would also perform RA/RB to confirm the group on the sample. 

I believe we are moving towards the 2 sample policy and can then bring in electronic XM. Until then I will spend my time doing all these IS crossmatches. 

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Posted (edited)

Do you run any control with this process ? With IAT crossmatch we use OR1r cell with weak antiD. 

Edited by gagpinks

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2 hours ago, gagpinks said:

Hi

Does anyone use immediate spin method for crossmatch?  Do you require any control in this process? I personally don't prefer this method especially when you have robust IT system and 2 sample policy. 

NHSBT certainly uses the "immediate spin" cross-match in cases of AIHA when no atypical allo-antibodies have been detected underneath the auto-antibody.  That having been said, particularly with the two sample policy and a robust IT system (and the guarantee by NHSBT that what is printed on the unit label vis-a-vis the unit group, is what is the unit group) an electronic issue (there is no such thing as an electronic cross-match - that is rather like calling the Rh Blood Group System either the Rhesus or rhesus Blood Group System), whereby there is minimal human intervention, I agree that electronic issue is far, far safer than an "immediate-spin" cross-match.

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4 minutes ago, Malcolm Needs said:

NHSBT certainly uses the "immediate spin" cross-match in cases of AIHA when no atypical allo-antibodies have been detected underneath the auto-antibody.  That having been said, particularly with the two sample policy and a robust IT system (and the guarantee by NHSBT that what is printed on the unit label vis-a-vis the unit group, is what is the unit group) an electronic issue (there is no such thing as an electronic cross-match - that is rather like calling the Rh Blood Group System either the Rhesus or rhesus Blood Group System), whereby there is minimal human intervention, I agree that electronic issue is far, far safer than an "immediate-spin" cross-match.

Reviewing this process so just wondering did you use any control with this process? Do we need to run control ? Can't find in guidelines 

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26 minutes ago, gagpinks said:

Do you run any control with this process ? With IAT crossmatch we use OR1r cell with weak antiD. 

No, we don't run any controls with it. 

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9 minutes ago, gagpinks said:

Reviewing this process so just wondering did you use any control with this process? Do we need to run control ? Can't find in guidelines 

No, we didn't, because the controls for electronic issue were controls on how the IT programme works (or doesn't) by testing the programme "to destruction" before it was allowed to "go live".  There is no way (that I know of) to control that any antibody can be detected following allo-adsorption (as the adsorption cells will, almost certainly be positive for high prevalence antigens (and so will adsorb out such antibodies such as anti-Lan) and, in any case, no antibody screening cells or panel cells will express every low prevalence antigen.  In other words, no transfusion is safe (unless the patient will expire without it, the safest transfusion is that which is never given).

I think what I am trying to say is that you can only do your best.  No transfusion is ever 100% safe, but you cannot control everything (even the MHRA and UKAS admit that - and that is saying something!), but, unless you can come up with something that many people (including some of the "greats" of blood transfusion) have overlooked for years, then there are some situations where it is impossible to run controls that are not just there as a sop to the person running the tests.

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We use it during a computer downtime when the transfusion is needed before the computers come back up. Then once the computers come back up the units are retroactivity computer xm/dispensed

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Could the Daily/Day of Use QC for the ABO Plasma Grouping Cells ( A1 and B ) be considered a positive and negative control for the saline crossmatch?  In both cases these tests use patient serum/plasma added to donor red cells, the only difference being that the ABO Plasma Grouping cells are stored in solution designed to maintain agglutinability  while the donor cells are stored in a solution designed to maintain oxygen transport.

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we did try this but apparently, it works very weekly than expected.  

On 5/21/2019 at 6:40 AM, Dansket said:

Could the Daily/Day of Use QC for the ABO Plasma Grouping Cells ( A1 and B ) be considered a positive and negative control for the saline crossmatch?  In both cases these tests use patient serum/plasma added to donor red cells, the only difference being that the ABO Plasma Grouping cells are stored in solution designed to maintain agglutinability  while the donor cells are stored in a solution designed to maintain oxygen transport.

 

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On ‎5‎/‎21‎/‎2019 at 1:40 AM, Dansket said:

Could the Daily/Day of Use QC for the ABO Plasma Grouping Cells ( A1 and B ) be considered a positive and negative control for the saline crossmatch?  In both cases these tests use patient serum/plasma added to donor red cells, the only difference being that the ABO Plasma Grouping cells are stored in solution designed to maintain agglutinability  while the donor cells are stored in a solution designed to maintain oxygen transport.

If I understand the question, I think that you could say that any negative reverse reaction on the patient's ABO typing would serve as a negative control--however, this would not be good enough for O patients.  For a positive control, you would likewise be stuck on AB patients.  But I do not think that patient specimens are regulated as "QC-able" materials in the  case of a IS XM.

Regardless, I would think that the "pos/neg" QC regulations are concerned with validating reagent reactivity and system integrity, and not so much with one patient's specimen reacting with another's RBCS. 

Scott

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