Antibody Identification and Patient Antigen typing timeline

[John W.]

I work as part of a 10 hospital health system. Currently, antibody identifications are sent to the main campus to perform usually as a costly STAT transport. We are looking at implementing antibody identification at the satellite hospitals but the cost of the additional anti-sera is pushing this to be more expensive than the STAT transport. All satellite sites send RBC unit segments to our main campus, who performs all the non-ABORH antigen testing for RBC units for the other 9 hospitals. Have you heard of having site A perform the antibody identification but then have the patient antigen test sent to site B?

I've been going through AABB Tech Manual/Standards and AABB/CAP Checklists and cannot find anything that explicitly states patient antigen typing must be performed, but should be used to support the antibody identification.

Scenario:

Patient ABID performed at site A (satellite). Site B (main) performs antigen typing for RBC units at site A. Site B notifies site A which unit to crossmatch. Site A crossmatches RBC unit, compatible. Patient antigen typing sent to Site B on routine courier to be performed within 24 hours.

Also, to reduce competency/proficiency testing needs, we are looking at having the satellite sites loading the ABID panel on their Echo analyzer but having the main campus still perform actual antibody identification/interpretation. Satellite site would print off the Echo result and fax/email the result and antigram to main campus. Has anyone else attempted this? If yes, what were your biggest hurdles? We are looking into ImmuLINK to allow the main campus to have access to the satellite Echos, but this probably will not make it through financial approvals .

[SbbPerson ☆]

7 hours ago, John W. said:

I work as part of a 10 hospital health system. Currently, antibody identifications are sent to the main campus to perform usually as a costly STAT transport. We are looking at implementing antibody identification at the satellite hospitals but the cost of the additional anti-sera is pushing this to be more expensive than the STAT transport. All satellite sites send RBC unit segments to our main campus, who performs all the non-ABORH antigen testing for RBC units for the other 9 hospitals. Have you heard of having site A perform the antibody identification but then have the patient antigen test sent to site B?

I've been going through AABB Tech Manual/Standards and AABB/CAP Checklists and cannot find anything that explicitly states patient antigen typing must be performed, but should be used to support the antibody identification.

Scenario:

Patient ABID performed at site A (satellite). Site B (main) performs antigen typing for RBC units at site A. Site B notifies site A which unit to crossmatch. Site A crossmatches RBC unit, compatible. Patient antigen typing sent to Site B on routine courier to be performed within 24 hours.

Also, to reduce competency/proficiency testing needs, we are looking at having the satellite sites loading the ABID panel on their Echo analyzer but having the main campus still perform actual antibody identification/interpretation. Satellite site would print off the Echo result and fax/email the result and antigram to main campus. Has anyone else attempted this? If yes, what were your biggest hurdles? We are looking into ImmuLINK to allow the main campus to have access to the satellite Echos, but this probably will not make it through financial approvals .

Under the AABB Standards for Blood banks and Transfusion services(1st. ed. 04/2021), the recipients' red cells must phenotypically match the donor cells, i.e. it does not contain the corresponding antigen(s) to the recipient's antibody(ies).  

 

I think the main idea is that the best blood to give to a patient is "type specific" blood.   So that include the ABO/Rh antigens and all other clinically significant antigens that may trigger an immune response. 

 

5.14.3

When clinically significant red cell antibodies are detected or the recipient has a history of such antibodies, Whole Blood or Red Blood Cell components shall be prepared for transfusion that do not contain the corresponding antigen and/or are serologically crossmatch-compatible to include anti-globulin testing.

 

 

 

 

 

 

[sgrassley]

If all of your hospitals are using the same Immulink interface, you probably already have access to view the testing. If you have permission to add users, you can add the 2nd location under 'Manage Users'. 

[Mabel Adams]

We accept patient (and unit) antigen typing done at our reference lab.  I don't see why this would be different.  You are there reference lab for anything that is beyond their limited ABID scope, right?