L106 Posted November 16, 2008 Share Posted November 16, 2008 Likewise, we only use Anti-A,B to retype donor units. Link to comment Share on other sites More sharing options...
noelrbrown Posted November 19, 2008 Share Posted November 19, 2008 So I am reading this post with interest and couldnt resist adding my 2 cents or rather 2 pence as i am British. When we made polyclonal (human) anti A and B we always used a polyclonal anti A,B because when Anti A and Anti B are present in conjunction with one another they will detect subgroups of A much better than plain old Human Anti A. Its very important to pick up subgroups of A and also difficult because a lot of them will produce anti A1. Therefore a good test is to check all presumed newly identified group B's with A2 cells as a reverse type to ensure they are not an A4B. Now on to Monoclonal reagents. Most of them do detect A3 and some A4/Ax cells however there are a few A subgroup variants that are not detected by Anti A alone and need an Anti A,B. There are many many subgroups of A identified from different regions of the world eg. A Bantu. There lies the problem in that most commercial Anti A,B are a blend of anti A and Anti B and dont really offer much benefit over using the reagents individually. There is however a commercial product being sold in the USA which is an Anti A,B that is a blend of 3 monoclonal antibodies and they are Anti A, Anti B and a true Anti A,B (ES15 clone). Due to restrictions promoting commercial products on this website I cannot indicate which manufacturer supplies this reagent but they are an advertiser here. Link to comment Share on other sites More sharing options...
Mabel Adams Posted November 19, 2008 Share Posted November 19, 2008 Although important for donor centers and truly accurate typing, I wonder at the value of using A2 cells for a reverse type on newly identified group B patients (i.e. recipients). Missing a very weak subgroup of A and calling the patient B instead of A4B would hardly do any harm in any circumstances I can think of. Most of us would not seek out A units lacking the A1 antigen for these patients but would give B or O. It seems like sometimes it is safer to miss very weak antigens and treat the patient as though he is negative than to confuse matters with the complicated truth. Maybe a sad state of affairs, but true. That said, molecular testing is showing that the "truth" of someone's blood type is not nearly as clearcut as we once believed. Link to comment Share on other sites More sharing options...
noelrbrown Posted November 19, 2008 Share Posted November 19, 2008 Although important for donor centers and truly accurate typing, I wonder at the value of using A2 cells for a reverse type on newly identified group B patients (i.e. recipients). Missing a very weak subgroup of A and calling the patient B instead of A4B would hardly do any harm in any circumstances I can think of. Most of us would not seek out A units lacking the A1 antigen for these patients but would give B or O. It seems like sometimes it is safer to miss very weak antigens and treat the patient as though he is negative than to confuse matters with the complicated truth. Maybe a sad state of affairs, but true. That said, molecular testing is showing that the "truth" of someone's blood type is not nearly as clearcut as we once believed.Yes i was posting from a Donor perspective and in a hospital you would not like to recieve a unit labelled B which was AB, however in the case of ABO antigens if I was still practising I would like to believe I got all patient ABO's correct. I understand your comment about safer to miss weak antigens and agree that you can afford to do that in the Rhesus system.regards,Noel Link to comment Share on other sites More sharing options...
silverblood Posted December 4, 2009 Share Posted December 4, 2009 Can't believe that someone would actually admit to doing something as irresponsible as this.............. Link to comment Share on other sites More sharing options...
silverblood Posted December 4, 2009 Share Posted December 4, 2009 Ah! The old days! I can still remember going around to the nursing stations looking for urine. I usually had no trouble getting any, as I took care of the nurses on my shift by running this test and that one for them, usually pregnancy tests, although one particular nurse always needed a CBC. I did break her of that "need" one night by running the low control through the analyzer and faxing that to her. I gave her 5 minutes to absord the results, then called to say "April fool." However, she had already called her supervisor to replace her, clocked out, and presented to the ER with an urgent need for transfusion. She never asked for a freebie again.BCCan't believe that someone would actually admit to doing something so irresponsible............................. Link to comment Share on other sites More sharing options...
Mabel Adams Posted December 5, 2009 Share Posted December 5, 2009 To which post were you referring as showing irresponsibility? Link to comment Share on other sites More sharing options...
silverblood Posted December 5, 2009 Share Posted December 5, 2009 So sorry if I offended. I was replying to the massage that someone wrote about sending a bogus lab report making an individual think that they needed to be transfused-I think I unwittingly tagged my reply to the wrong message-I am new to this blog................... Link to comment Share on other sites More sharing options...
Mabel Adams Posted December 5, 2009 Share Posted December 5, 2009 No offense taken. I just wasn't sure what you were referring to and hoped it wasn't my post. I still often post in response to something on page one of the thread forgetting that it will appear at the end, sometimes of numerous pages, and therefore context will be lost. I often forget to use the quote function that can help with this. Welcome and no worries. Link to comment Share on other sites More sharing options...
maxon Posted December 5, 2009 Share Posted December 5, 2009 We haven't used A,B since beore I started in 1991 here. Ditch it! Link to comment Share on other sites More sharing options...
PaulSunV Posted December 7, 2009 Share Posted December 7, 2009 (edited) I am actually, as a result of this thread, now considering discontinuing having this product available or in the alternative having another facility sell me one bottle a year.At the hospital I work as a PRN they use A,B for donor unit verification only. Edited December 7, 2009 by PaulSunV punctuation Link to comment Share on other sites More sharing options...
Malcolm Needs ☆ Posted December 7, 2009 Share Posted December 7, 2009 Heaven help the definitions when they finish DNA profiling of them.Well Mabel, I had the great honour of hearing Martin Olsson give a lecture at the Royal College of Pathologists at Doug Voak's retirement do a few years ago. It was absolutely fascinating.He was saying that, even then, there were over 80 different kinds of genetic backgrounds to the A transferase, but that, even then it wasn't that simple! For example, the transferase resulting in an Ax in Finland (say) is quite different to the transferase resulting in an Ax in Japan (say), but that all those in Finland (or, at least, around one area of Finland) were genetically identical, and the same goes for the (area) of Japan. So the genotype may differ, but the phenotype is similar.Personally, I wish they'ed never started doing this kind of thing. Makes us serologists feel redundant!PaulSunV, more power to your elbow! Get rid of the anti-A,B. It pays for suppliers holidays.:) Link to comment Share on other sites More sharing options...
adiescast Posted December 8, 2009 Share Posted December 8, 2009 PaulSunV, more power to your elbow! Get rid of the anti-A,B. It pays for suppliers holidays.:)Heaven forbid that we should allow suppliers to go on holiday! Link to comment Share on other sites More sharing options...
Malcolm Needs ☆ Posted December 8, 2009 Share Posted December 8, 2009 Heaven forbid that we should allow suppliers to go on holiday!No, no, they should be allowed to go on holiday, and, of course, some of the money we pay towards the reagents must pay towards these holidays (reasonble profits). There is a difference between them selling excellent reagents and reagents that are just a mixture of others, on the mis-guided premise that we actually need them.The difference between a 5 star hotel and a 4 star hotel!!!!!!!!!!! Link to comment Share on other sites More sharing options...
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