lab217 Posted May 30, 2012 Share Posted May 30, 2012 A question has stirred some heated discussions in our blood bank. Any input would be greatly welcomed. The question is "if a known antibody is not detected/reacting on a cell, can this cell be used to rule out other antigens?" Link to comment Share on other sites More sharing options...
SMILLER Posted May 30, 2012 Share Posted May 30, 2012 Yes, but what is the argument against it?Scott Link to comment Share on other sites More sharing options...
Malcolm Needs ☆ Posted May 30, 2012 Share Posted May 30, 2012 Agree with Scott, but would also like to know the argument against it. Link to comment Share on other sites More sharing options...
Mabel Adams Posted May 30, 2012 Share Posted May 30, 2012 Agreed. Link to comment Share on other sites More sharing options...
lab217 Posted May 31, 2012 Author Share Posted May 31, 2012 LOL, loving the concensus! The philosophy, as explained, was that the results were not as "expected" and therefore should not be used to rule out other antigens. Gaging the responses, I will deduce that this is not a common practice or even an "old school philosophy".As always, thanks for the prompt responses! Link to comment Share on other sites More sharing options...
Nisar Posted May 31, 2012 Share Posted May 31, 2012 A question has stirred some heated discussions in our blood bank. Any input would be greatly welcomed. The question is "if a known antibody is not detected/reacting on a cell, can this cell be used to rule out other antigens?"We cant rule out on that cell as that cell even should not be used for screening,because we are using selective panel for screening in such patient,then how this question can arise:cries: Link to comment Share on other sites More sharing options...
lab217 Posted May 31, 2012 Author Share Posted May 31, 2012 With our automation "ECHO" solid phase technology, we do not have the luxury for "cell" selection. Immucor makes the panels and our facility purchases three different types of panels. We have to run the panel of all 14 cells so disregarding cells would make our job much more difficult. On a side note, their single dose vs double dose cell selection on much of their panels complicates ruling out with in-house policy. The comparison of tube method to the hyper-sensitivity of the ECHO is like comparing apples and oranges, they are definitely not the same beast. Link to comment Share on other sites More sharing options...
Rh-fan Posted May 31, 2012 Share Posted May 31, 2012 If you have a strong reactive anti Fya, and a Fya pos cell is not reactive, there is a change that the wrong cell is used, and therefore you can not use that cell for further exclusion (because the typing is not sure).If it is a missing reaction with a weak antibody (and the non-reactivity can be explaned) then I would use the cell for further ruling out.It all depends on the situation. (just as everything in this field)Peter Link to comment Share on other sites More sharing options...
Changezi Posted May 31, 2012 Share Posted May 31, 2012 Simply performing QC we are using know cells and known antibodies. if it not works means some thing is wronge. why thats another discussion but all in all QC fail. So i think we cann't use that cell . Link to comment Share on other sites More sharing options...
SMILLER Posted May 31, 2012 Share Posted May 31, 2012 If a historically positive anti-E (or whatever) patient is coming up on all screening cells as negative, I don't seeaproblem in using them as rule-outs. In this situation, I would just go to a coombs crossmatch with the appropriatly screened units. On the other hand: if you are getting some positive E cells negative AND some positive, either on the screening cells or in a panel, even if all else is ruled out, I agree you would have to look at it a bit closer.Scott Link to comment Share on other sites More sharing options...
Nisar Posted May 31, 2012 Share Posted May 31, 2012 A question has stirred some heated discussions in our blood bank. Any input would be greatly welcomed. The question is "if a known antibody is not detected/reacting on a cell, can this cell be used to rule out other antigens?"I dont know about your system but keeping the space empty for the unwanted cells then it will take those available cells only and you will read the selected panel results,take care Link to comment Share on other sites More sharing options...
Barbarakym Posted May 31, 2012 Share Posted May 31, 2012 A question has stirred some heated discussions in our blood bank. Any input would be greatly welcomed. The question is "if a known antibody is not detected/reacting on a cell, can this cell be used to rule out other antigens?"EX: Pt has Anti FyaI totally agree it can be used and do so. Looking for a K on a Fya cell and the cell is Negative one can use that as one of the cells to rule out K.I also want to RULE in what antibodies are present. So I would still look to rule out the FYa and would not accept heterozgyous cells to do that. But 1 Homozgyous yes or no is enough to rule in/out the previous antibody. I like to know this for FYI only. I have found patients going to other hospitals and getting blood by this method when my previous Anti E for example not having been shown in 3 years all of a sudden is 3+. Link to comment Share on other sites More sharing options...
Liz0316 Posted June 2, 2012 Share Posted June 2, 2012 Firstly, I have to wonder why you are running cells that are positive for an already known antibody. You should be "honoring" the history of the antibody anyway, so selected cells should be chosen that are negative for the "known" antibody. However, to answer your question, I would ask my techs to run cells that are negative for the "known" to rule out other clinically significant antibodies. Hope that helps. Link to comment Share on other sites More sharing options...
Barbarakym Posted June 2, 2012 Share Posted June 2, 2012 Firstly, I have to wonder why you are running cells that are positive for an already known antibody. You should be "honoring" the history of the antibody anyway, so selected cells should be chosen that are negative for the "known" antibody. However, to answer your question, I would ask my techs to run cells that are negative for the "known" to rule out other clinically significant antibodies. Hope that helps.1. Not all hospitals run rule out panels initially even with known antibodies. Thus there will be positive cells for those antibodies on the full panel. When the antibody is no longer showing and that cell is negative then that cell can be used to rule out other antibodies. 2. In my BB, as I stated above, I want to verify what is present in that specimen. So at least 1 homozygous cell for that antibody which is negative for the other antibodies pres must be run. As I stated this has helped me verify the patient received blood elsewhere Allowing us to make sure her records were complete at both places. This has happened on several occasions. Reference lab work when sent out this is also done. Link to comment Share on other sites More sharing options...
Mabel Adams Posted June 2, 2012 Share Posted June 2, 2012 I assumed that the historical antibody was no longer detectable or only barely, so I would then use a pos cell to rule out additional antibodies. If it were an isolated negative, I agree with those above that would look into it further. Link to comment Share on other sites More sharing options...
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