Donor Antibody Screening

[ncehall]

We are a hospital based Donor Center and perform antibody screens only on donors who have ever been pregnant or transfused. We are evaluating this policy and would like to get an idea of other Blood Centers' practices. Do you perform antibody screens on all donors?

[John C. Staley]

First let me say that I was not aware that antibody screening donors was optional based on history. Having said that, years ago I supervised a hospital based full service bloodbank. Our philosophy was always that is was easier and safer to treat all donors the same than it was to try to single out those who were different. Case in point was the autologous donors. We tested them just as if they were regular donors. It was easier, more efficient and, in my mind, safer that way.

So I guess the short answer is that all donors, every donation, had an antibody screen performed.

[ncehall]

John- Thanks for your input. I think our policy was developed based on this standard: "Serum or plasma from donors with a history of transfusion or pregnancy shall be tested for unexpected antibodies to red cell antigens".

[David Saikin]

We always did abscr on all donors.

[Jaimie Nicholson]

Sounds like a bad idea to me... donors might lie, or just not know. For example, a woman who lost her baby in the first few months might have formed antibodies, but if you ask her, even if she knew, she might not think it counts as having been pregnant. And unlikely as it seems, some people might be confused about whether they were given blood or not.

[Malcolm Needs ☆]

I agree that it is a bad idea.

When working at Westminster Hospital (now closed) I tested a Jehovah's Witness who swore blind that he had never been transfused; he had one of the strongest anti-Fya's I'd ever seen!

[Abdulhameed Al-Attas]

I also agree that it is a bad idea,

We do Antibody screen on all donors,we do not do Panels if found positive we just discard the unit and related components.

[Fluffy agglutinates]

Don't do panels! But what if you throw away something special? Like a Bombay donor perhaps?

[conwaysbb]

There is an additional issue that would need to be addressed if the antibody screen is not performed on the donor. I refer you to CFR 606.151 Compatibility testing which states:

"Standard operating procedures for compatibility testing shall include the following:

(d) a provision that, if the unit of donor's blood has not beeen screened by a method that will demonstrate agglutinating, coating and hemolytic antibodies, the recipient's calls shall be tested with the donor's serum (minor crossmatch) by a method that will so demonstate."

As your antibody screen is your method that demonstrates the agglutinating, coating and hemolytic antibodies, then not performing this test would require you to perform these minor crossmatches. Are you currently performing the minor crossmatch.

Remember, the FDA has jurisdiction even if you are not licensed or registered as a blood collection facility. They can even inspect you as a transfusion service to see that you are following their CFR requirements.

Even if you do choose only to do perform antibody screens on only those donors that have a history of being transfused or pregnant, how are you identifying these units. How will your staff now know which units you have to do minor croosmatches on and do you really want to have 2 different procedures for your staff to follow?

[Malcolm Needs ☆]

Don't do panels! But what if you throw away something special? Like a Bombay donor perhaps?

Absolutely right Fluffy agglutinates. I actually know of a unit of Oh being thrown out because the antibody was not identified!