CLiaa & Prewarming Procedures

[Malcolm Needs ☆]

I remember an article in the journal Immunohematology from 1994 titled:

Misidentification of anti-Vel due to inappropriate use of prewarming and adsorption techniques

Authors: J R Storry, D Mallory

Immunohematology / American Red Cro.... 02/1994; 10(3):83-6.

...later. Retrospective testing in our laboratory detected anti-Vel in both pretransfusion... examples of anti- Vel at the IAT. The posttranshision serum was grossly hemolyzed and anti-Vel... hemolysis) was strongly reactive (3+s) with Vel+ RBCs but compatible with 10 examples of Vel- RBCs...

The authors reported a fatal hemolytic reaction after the referring laboratory used the pre-warm technique in the rbc panel and crossmatches.

Granted anti-Vel is uncommon, but it seems that sufficient examples showing missed clinically significant antibodies using the pre-warm technique should justify caution in any investigation.

I have a huge respect for Jill and Delores, but I regret to say that I have not read this paper (an error that will be put right at the very next opportunity), but I would love to know if the pre-transfusion auto was positive in this case. If it was not, then adsorption was totally inappropriate until the specificity had been ascertained. Then, and only then, adorption to reveal any other underlying atypical alloantibodies would be appropriate.

In my experience, anti-Vel can be even more of a pain to identify than anti-Jka. I know of one case, which was fatal, where the anti-Vel could only be detected using serum (because of the complement) and was never detected in plasma.

:eek::eek:

[adiescast]

In my experience, anti-Vel can be even more of a pain to identify than anti-Jka. I know of one case, which was fatal, where the anti-Vel could only be detected using serum (because of the complement) and was never detected in plasma.

:eek::eek:

OUCH! We would have missed that one for sure. We almost never get serum anymore!

[Malcolm Needs ☆]

OUCH! We would have missed that one for sure. We almost never get serum anymore!

Same here - scarey huh???!!!!!!!!!

:fear::fear: