janet Posted June 11, 2007 Share Posted June 11, 2007 How often does 'everyone' redo workups on patients who react with all cells tested? Our practice is to autoabsorb and do a full phenotype before transfusing. Attempt to transfuse phenotypically matched units to prevent allo-antibody production. We redo antibody screen, panel, DAT and crossmatch every 3 days - only to find the patient still reacts with everything (what we knew was going to happen). Link to comment Share on other sites More sharing options...
rcurrie Posted June 11, 2007 Share Posted June 11, 2007 We do pretty much the same thing. The idea is to detect that brand new underlying allo that patients with autos tend to make. I am in favor of doing all this on a less frequent basis (say once a week) in patients being transfused. Not my call, though.BC Link to comment Share on other sites More sharing options...
Yanxia Posted June 13, 2007 Share Posted June 13, 2007 If the autoantibody react more strongly with one antigen like E, what will you do ? Link to comment Share on other sites More sharing options...
rcurrie Posted June 13, 2007 Share Posted June 13, 2007 We respect the specificity and give E-negative units, crossmatch-compatible with adsorbed plasma.BC Link to comment Share on other sites More sharing options...
Liz Posted June 13, 2007 Share Posted June 13, 2007 How often does 'everyone' redo workups on patients who react with all cells tested? Our practice is to autoabsorb and do a full phenotype before transfusing. Attempt to transfuse phenotypically matched units to prevent allo-antibody production. We redo antibody screen, panel, DAT and crossmatch every 3 days - only to find the patient still reacts with everything (what we knew was going to happen). What kit / method do you use to autoabsorb? Thanks Link to comment Share on other sites More sharing options...
Jane Posted June 13, 2007 Share Posted June 13, 2007 We redo the DAT and antibody screen. If results are no stronger we only redo the autoabsorption every 2 weeks. Or have it done that is- we send ours out to the ARC ref lab. Link to comment Share on other sites More sharing options...
Mabel Adams Posted June 13, 2007 Share Posted June 13, 2007 We would repeat workup after 3 days IF patient has been transfused. Otherwise, we don't repeat until 3 days post transfusion. Since the first workup often takes a day or more that buys us some time for the steroids to kick in usually. Of course, I find these nuances are rather difficult to convince our Meditech computer of. Link to comment Share on other sites More sharing options...
Eagle Eye Posted June 13, 2007 Share Posted June 13, 2007 We use W.A.R.M. (immucor reagent) for autoabsorbtion. Link to comment Share on other sites More sharing options...
rcurrie Posted June 14, 2007 Share Posted June 14, 2007 We use W.A.R.M., but I have been experimenting with PEG autoadsortions and they work perty derned good. It only takes 15 minutes to do a PEG adsorption. The last one I did went from a 3+ to negative, but you can do a second adsorption if the plasma is still reactive with all cells.BC Link to comment Share on other sites More sharing options...
Liz Posted June 14, 2007 Share Posted June 14, 2007 thank you Link to comment Share on other sites More sharing options...
Eagle Eye Posted June 15, 2007 Share Posted June 15, 2007 I think there are several articles regarding PEG autoadsorption missing some antibodies??? What is your experience??Do you use 4 drops of PEG-adsorbed serum or 6 drops?? Link to comment Share on other sites More sharing options...
rcurrie Posted June 16, 2007 Share Posted June 16, 2007 I am not sure what you mean by "missing some autoantibodies", as PEG is merely an enhancement to the autoantibody uptake on the autologous cells. The idea is to remove the autoantibody (usually of Rh specificity) and then test the absorbed plasma for underlying allos. You use 4 drops of the absorbed plasma (half plasma and half PEG), with no additional PEG (it's in there already!). You can go to 6 drops if you suspect a weak antibody. All this is spelled out in the tech manual. I like it! You can also do a second adsorption if there is still remaining autoantibody in the plasma, as indicated by all cells reacting on the panel after the first adsorption.BC Link to comment Share on other sites More sharing options...
Eagle Eye Posted June 16, 2007 Share Posted June 16, 2007 Some time I am too quick.... sorry for my ignorance...I read the tech manual procedure which already talks about limitations of the procedure. I may try this because it is very quick, because W.A.R.M. is too long. If I have enough sample I will run both on same sample. Link to comment Share on other sites More sharing options...
Yanxia Posted June 17, 2007 Share Posted June 17, 2007 My teacher said PEG as an enhancement reagent will nonspecific uptake antibodies, so we normally test with a negative control(use AB serum have not irregular antibodies). Mybe it will uptake alloantibodies with autologous cell. I have not use this reagent before, this is just my guess. Mybe there is some method to avoid the nonspecific enhancement which I don't know. Link to comment Share on other sites More sharing options...
David Saikin Posted July 5, 2007 Share Posted July 5, 2007 We use the PeG autoabsorbtion . . . it is fast and reliable. I've never had any success using WARM (though I do use this to destroy Kell ags). and PeG sure beats the old enzyme pretreatment and heat and the hours this took. Link to comment Share on other sites More sharing options...
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