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Re-typing Donor blood


amyw_3
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I'm only a year out of MT school and now the blood bank supervisor at a small hospital. I was wondering what kind of testing you all do on donor blood. We receive our units from Lifeblood and currently do ABORH on all units and additional weak D testing on the negative units. Reading the technical manual I take it that we only need to be doing ABO on units labeled positive and ABORH on units labeled negative with no weak D testing. Is this common practice or do most still do the additional testing? Also, would it be acceptable to just change this procedure or is there more to it than that? THanks for your help.

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We follow the Tech Manual for retypes: just recheck Rh type on RhPos units with no WeakD testing. We use Anti-A,B on Group O units, instead of Anti-A and Anti-B -- local tradition, more than necesssity.

You should follow your change control procedure for making any changes. For us, this involves getting the MD approval, validating any computer modifications, revising the SOPs, retraining staff, implementing the change, and writing an after-action report.

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Congratulations on your quick advancement to a supervisor position! I think you will find this site to be a wealth of helpful information.

We don't carry anti-A,B so we test with anti-A and anti-B. We test immediate spin D's only on the Rh neg units. For those of you using A,B and an LIS, did you make a separate field to result the A,B instead of the anti-A and anti-B?

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We do a forward grouping using Anti-A and Anti-B reagents on all donor units received from an outside source. Exception: If the tech prefers, she/he may perform the forward grouping using only Anti-A,B reagent (instead of using Anti-A and Anti-B reagents) on donor units labeled as Group O.

We do a one-tube Rh typing (immediate spin only) using Anti-D on all donor units from an outside source that are labeled as Rh Negative. We do not perform the Weak D testing.

Concerning our computer system, we do have a separate field (which is an "optional" field) for Anti-A,B results. We built and validated the ABO Truth Table of our "Donor Confirmation" testing to accept the interpretation of "Group O" if there are no results in the Anti-A or Anti-B fields and the results in the Anti-A,B field is "Neg".

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We do forward grouping using anti-A & anti-B reagent on all donors. We do RH typing on all Rh neg donors including weak D but Weak D is not required and we are in process of changing it but need to chage LIS. and as usual our LIS deparment is not very helpful when it comes to making changes fro blood bank and most of the time I end up doing that for them.

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Does it specifically say in the Technical Manual that you can use A,B for the ABO on Group O or is this just understood? I am trying to revise my policy and I can't really find that. Thanks for any help!!

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The standards and Tech Manual just say that a serologic test to confirm the ABO group must be performed. I like the use of Anti-A,B because it is quicker, less wasteful, and occasionally you can pick up that weak A subgroup that doesn't always show with Anti-A.

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We use the ProVue to retype units. We use A,B cards for O pos units, Anti-A and Anti-B (on a single card) for A pos and B pos units and Anti-A, Anti-B and Anti-D for all Rh negative units. We don't stock AB units so don't have to deal with them.

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We call it group checking, and we use instant spin tube technique. We test O units with anti-A,B, and all the other types with anti-A and anti-B, and additonally all Rh(D) negative units with anti-D. Weak D testing is not considered necessary. We didn't do any of that until we started electronic issuing, though, before that we did an instant spin crossmatch before all issues, and that was considered sufficient.

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Most of the anti-A,B on the market these days is just a mixture of monoclonal anti-A and monoclonal anti-B, isn't it? Unless they have made it simply stronger, it should not be better at picking up subgroups. Do you know if the one you use is monoclonal or formulated with higher titers?

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We use Immucor Series 1 which is a monoclonal blend. It is a blend of Anti-A (series 1), Anti-B (series 1) and another clone. We did pick up a weak subgroup of A last year that was negative with Anti-A (series 1) and very weakly positive with Anti-A,B (series 1). We sent the unit back to the supplier.

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