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Hello all, 

I am not sure how to ask this question so I hope to not confuse you. Currently the blood bank I work at is restructuring due to a mass loss of employees recently. There are many things that have been overlooked for some time and now are being addressed. One is the lack of clarity regarding our process for identifying clinically significant antibodies. There is no clear process in place other than it is best to rule out with the 3pos/3neg rule. This has caused a lot of confusion for staff because this is not always possible. And often different staff members have a different idea on how this should look. I would like to put together a this-then-that kind of approach for rule outs but I am fairly new and feel a little overwhelmed with this project. I have been reading my tech manual and thought it was discussed in more detail but have yet to find clear instruction. What approach have you taken to standardize antibody ID? 

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Our antibody-ID section in our procedure manual has gotten a bit bloated, but only because it is reasonably comprehensive.  While we, like many, use the "3x3" rule, it becomes more involved when you start looking at individual antigens and antibody characteristics.  (For example, a patient that is only producing anti-E is likely to start producing anti-c after they are transfused a few times.  For this reason, most labs will screen units for anti-c for c-antigen negative patients producing anti-E.) 

Also, there are other considerations for certain situations, (such as a patient with a previously identified antibody need not have 3 positive cells to rule it in). 

In general, we have a procedure that details the 3x3 step by step.  Then there are individual charts, tips, and notes for common specifics regarding certain situations, such as how to get around cold agglutinins, or the use of enzymes. 

You should be able to figure out what to put in your procedure from looking at the AABB manual.  If your current procedure for antibody ID seems totally inadequate, you may want to start from scratch.

Hope this helps.  Antibody ID is the most robust procedure we have in our BB manual.

Scott

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