Retention of records for patients with passive Anti-D injection

[YorkshireExile 23]

CAP / AABB  state that any records of transfusion problems, such as finding unexpected antibodies, should be retained indefinitely. Does this apply to patients who have a positive antibody screen only because they have recently received a confirmed prophylactic passive anti-D injection? Or do I only need to keep the antigrams of these patients for ten years? Or I don`t need to save them at all? Wondering what other facilities do with these patients?

[jayinsat 168]

We use MEDITECH MAGIC 5.6.7. Long ago, we started entering our Immucor Cell Panel lots into the QC function, along with the individual donor cell reactions. Over the years, our database has grown to where, every month, we only have to enter 1 or 2 new donor cell, out of the 16 on the panel, into the database when entering the new months donor panel. When we have a Passive D, we enter the cell reactions from the panel in the antibody ID field, which stores the reactions indefinitely in MEDITECH. That allows us to not have to keep the antigrams for passive D's. Everything is in the computer and easily accessible. BTW, doing it like this allows MEDITECH to calculate the antibody ID probability. It's a nice feature if you have the time to build and maintain it.

For all antibodies, we only keep the antigrams. Every other reaction is recorded and maintained indefinitely in MEDITECH and the ECHO backups.

Edited January 29 by jayinsat
forgot to add something

[AMcCord 1,296]

We are scanning all completed patient antigrams, worksheets, and reference reports into our BB LIS. That information is accessible (and printable) from the comment section of the patient profile.

[Malcolm Needs ★ 4,923]

In the UK, we keep these records indefinitely, as much as anything because the individual will have received something that is derived from human blood, and this may contain a de novo transfusion-transmitted viral infection, and so it is deemed that we need to know what batch and everything else about the injection (and the resulting antibody detected).

[Ensis01 127]

Indefinitely 

[slsmith 68]

Our facility saves for 10 years and then discards

[lalamb 66]

Related question: How long do u keep the anagrams of deceased persons?

 

[Malcolm Needs ★ 4,923]

In the UK, it is 30 years.

This is because we can be sued for up to 30 years after a death, if the death is thought, for example, by surviving relatives, to be suspicious

Edited February 16 by Malcolm Needs

[srichar3 22]

On 2/16/2021 at 6:14 PM, Malcolm Needs said:

In the UK, it is 30 years.

This is because we can be sued for up to 30 years after a death, if the death is thought, for example, by surviving relatives, to be suspicious

Wasn't 30 years due to vCJD risk? as the incubation period can be 20 years+ hence records need to be kept this long at least for tracing potential donor and other recipients from same donor? 

With regards to record keeping, in my experience in the UK while we kept the administration record of the anti-D the same as we did for all blood components/products, 30 years. Once we were satisfied that the anti-D was not of immune origin we would remove the record from the antibody file otherwise we would not be able to use electronic issue for future crossmatches.  Our LIS was such though that it would stay in the audit log of the patients file indefinitely that it was added then removed.  

[Malcolm Needs ★ 4,923]

9 hours ago, srichar3 said:

Wasn't 30 years due to vCJD risk? as the incubation period can be 20 years+ hence records need to be kept this long at least for tracing potential donor and other recipients from same donor? 

No, it was definitely due to the thirty year rule about the NHS being sued, as, when this was introduced (and explained in a booklet from the RCPath), the incubation period for vCJD was unknown, as the existence of the prion as an entity (if a prion can be called an entity) was "too new" (see the now rather ancient lecture on Prions that I submitted on here in around about 2006 - in the Library section).

Edited February 19 by Malcolm Needs

[Cliff 449]

On 2/15/2021 at 12:20 PM, lalamb said:

Related question: How long do u keep the anagrams of deceased persons?

 

If it was used as part of an antibody workup, I think AABB says indefinitely. 

[srichar3 22]

On 2/19/2021 at 8:13 PM, Malcolm Needs said:

No, it was definitely due to the thirty year rule about the NHS being sued, 

The thirty year rule came from the European blood directive 2002/98/EC, the NHS is only UK based, this was a European wide requirement.  

https://www.health-ni.gov.uk/articles/blood-safety-and-quality-regulations-2005-amended#:~:text=The Regulations,-The retention periods&text=Blood establishments and hospital blood,(regulations 8 and 9).

Also there is no such 30 year limit on suing the NHS, its 3 years from the date of discovery, so if you didn't find out until 50 years later then it would be 53 years. 

Applicable Time Limits To Sue The NHS

Claimant immediately aware that negligence had caused avoidable harm	3 years from the date of the negligent act
Claimant made aware later that negligence had caused avoidable harm	3 years from the date of the discovery
Those without capacity	No limit (There are some limits to those claiming on the injured party’s behalf – please see later sections or call our team for specific guidance)

Edited March 14 by srichar3
Spelling

[Darren 18]

We run our panels on the Vision analyzer and result them all in the LIS. I do not scan the antigrams. I keep a network folder of PDFs of all of the lots we use for referencing back to. Which in years and years we've never had to do.