How many times do you perform an antibody identification?

[froggymork]

We do a new panel and id every 72 hours. We send out to reference laboratory any that we get that are warm autos.

[gonneb25]

We only repeat the panel every 6 months unless we see increased reactivity in the screening cells and/or an incompatible antiglobulin crossmatch. We have not found any issues with this method. I had talked to one lab years ago that said they only do a new panel if the crossmatch is incompatible. After reviewing the other answers I think our process may raise a few eyebrows, but we did extensive validation. Also, we are using gel technology that I believe to be very sensitive and will not miss many clinically significant antibodies in our 13 years of experience with it. I am not sure what technology the other responders to this question are using.

[Malcolm Needs ☆]

It didn't raise my eyebrows; it gave me a complete face-lift!

I think that, so far, you have been lucky.

We've just dealt with a patient who, having made an anti-E+M+Fya+Jkb, and that's all for many years (almost ten in fact), suddenly produced a rip-roaring anti-Fy3 in three days. Sent an Hb of 7g/dL before transfusion down to 3.g/dL after transfusion!

:eek:

[keisterkid]

It didn't raise my eyebrows; it gave me a complete face-lift!

I think that, so far, you have been lucky.

We've just dealt with a patient who, having made an anti-E+M+Fya+Jkb, and that's all for many years (almost ten in fact), suddenly produced a rip-roaring anti-Fy3 in three days. Sent an Hb of 7g/dL before transfusion down to 3.g/dL after transfusion!

:eek:

We repeat panels every 14 days as long as the antibody screen results don't change and the antigen negative units are compatible. In the above scenario, the new sample crossmatched with E-, M-, Fy(a-), Jk(a-) some of the units should be incompatible; this would trigger our doing a complete workup on the patient.

[LaraT23]

I really cannot see any rationale for not repeating a panel. None. If a patient has a positive and it for example a Anti-D, Anti-E or something, who can say unless you do a panel that they are not making something else that happens to reside on the same screen cell as the others. Just can't take a chance.

I understand your "facelift" malcolm. I choked on my coffee reading that.

[Malcolm Needs ☆]

I understand your "facelift" malcolm. I choked on my coffee reading that.

Edited November 16, 2009 by Malcolm Needs

[LaraT23]

Ha Ha, I suppose if I was not from across the pond I might say you were a cheeky bugger! ha. Thanks for your ever present witt and most appreciated expertise as always.

[Malcolm Needs ☆]

I did mean my photograph on my Public Profile bit; honest!!!!!!!!

[RR1]

so, you've seen the photograph have you Lara????????!!!!!!!!!!!!!!!!!!!!!!!!!!!!

(I thought I had better say it before Rashmi does!!!!!).

:eek::eek:

Which decade was that taken then, or is this due to botox?????

[marquij@caribe.net]

We honor the previous identified antibodies and only do a selected panel every 72 hrs to detect any new antibodies.

[Mabel Adams]

Here's my logic: I want to give my patients with antibodies just as good a screen as my patients without. Since we insist that our screening cells be double-dose for most of the antigens listed, I want to test my patients with antibodies with double-dose cells also. This means that I usually have to use some panel cells to rule out all specificities the patient has not already made. I see no point in running a bunch of panel cells positive for the antigen to which the patient is known to have an antibody--we will honor that forever and only marginally care if it is still reacting. But I do want to run cells I expect to be negative so that I can properly rule out new antibodies. The one exception to running the whole panel instead of selected cells is that some automated platforms don't allow selected cell panels.

[Malcolm Needs ☆]

We honor the previous identified antibodies and only do a selected panel every 72 hrs to detect any new antibodies.

I can see nothing wrong with this. We do exactly the same following a pregnancy with an antibody.

An "abbreviated panel" that covers all the "other antigens" is just as safe as a full panel.

:)

[Joanne P. Scannell]

The 3 day rule for patients who have been pregnant or transfused within the past 3 months is there for a reason: Did the patient start making new antibodies or have old antibodies that were previously below detectibility now evident?

To answer that question, we don't need to re-identify known antibodies, we need to seek others, so run panel cells that will give you that information, e.g. If you have a patient who is known to be producing Anti-D and Anti-C, run D-neg, C-neg reagent cells from the panel.

So, yes, it is important to run a 'panel' every 3 days if the patient has been pregnant or transfused within the past 3 months.

[ABQ bloodbanker]

We repeat the entire workup with every new specimen..... 3 days for those that have been transfused within 3 months, and if the patient qualifies for a "Pre-Op" specimen, then it is good for 7 days. Our patients like to hospital hop - so finding accurate transfusion history is difficult. I would rather do the extra work instead of missing a newly forming antibody and deal with a hemolytic transfusion reaction later....

Denise

[ABQ bloodbanker]

The 3 day rule for patients who have been pregnant or transfused within the past 3 months is there for a reason: Did the patient start making new antibodies or have old antibodies that were previously below detectibility now evident?

To answer that question, we don't need to re-identify known antibodies, we need to seek others, so run panel cells that will give you that information, e.g. If you have a patient who is known to be producing Anti-D and Anti-C, run D-neg, C-neg reagent cells from the panel.

So, yes, it is important to run a 'panel' every 3 days if the patient has been pregnant or transfused within the past 3 months.

We also do NOT reidentify known antibodies....just look for new ones!

Denise