Titers

[Shashah]

We are trying to see if other hospitals routinely perform titers-- either Isoagglutinin titers (for example, a recent patient receiving a mismatched BMT, our medical director wanted us to titer the patient's Anti-B before and after the transplant until it disappeared) and/or Antibody titers in pregnant women with CSA's. We routinely do OB Antibody titers and have just seen an increase in Isoagglutinin titers, and we were wondering what this information is actually used for, ie if they are really necessary or don't need to be done as often as they are ordered here at our facility. What are your experiences with this, if any?

[Malcolm Needs ☆]

We are trying to see if other hospitals routinely perform titers-- either Isoagglutinin titers (for example, a recent patient receiving a mismatched BMT, our medical director wanted us to titer the patient's Anti-B before and after the transplant until it disappeared) and/or Antibody titers in pregnant women with CSA's. We routinely do OB Antibody titers and have just seen an increase in Isoagglutinin titers, and we were wondering what this information is actually used for, ie if they are really necessary or don't need to be done as often as they are ordered here at our facility. What are your experiences with this, if any?

It depends how often they are ordered.

Please could you give us some idea?

Thanks.

:confused::confused:

[marvy1]

In my previous experience in a reference lab, when we had a major ABO incompatability in a BMT, we would report whether the offending isoagglutinin was macro pos in the reverse. When the offending isoagglutinin became macro neg, we would perform a DAT (and elution if pos) to confirm the loss of the offending isoagglutinin. If the isoagglutinin was macro neg and DAT was neg, we would then switch to donor type. This protocol avoids the cumbersome titers and yet ensures the engraftment success.