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Clinically Insignificant antibodies


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I would like to know how to manage the crossmatch for clinically insignificant antibodies. (lea,P1, M, and when you have rhig D 
My computer program automatically defaults to a AHG XM. Can I perform ISXM for these antibodies if the antibody is no longer demonstrating?

 

Thanks,

 

ESizensky

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Some may continue to give M nagatve RBCs after it is no longer demonstrable depending on initial reactivity. It is OK to give immediate spin XM compatible for Lewis, P1 and RhIG when antibody is no longer detectable, IMO.

Edited by R1R2
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We are doing an anti M right now. It was pos on a specimen from the 1st...M homozygous reactivity...they shipped the patient to us with one emergency unit transfused(M pos of course) The tysc drawn today (on the 3rd) is negative. As a curiosity we were hunting for SOME reactivity in our specimen and did find a pos DAT. Our protocol for anti M is to either xm for comp or give M neg computer xm IF the anti M is reacting. Once the anti M is not reacting we go back to computer xm and M neg is no longer required. We decided to honor the pos from the 1st and continue long xm, though if they are a big user we will order or type for M antigen as it saves time especially on the short shifts.

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Our current SOP is to give electronically xm'd blood if the clinically insignificant antibody isn't demonstrating.

 

All though this is a wonderful idea in theory - in practice it could result in the accidental electronic issue of a clinically significant antibody. Take away the failsafe and you risk an error. We insist on full crossmatch for any new or historic antibody regardless of whether it is demonstratable or significant. It's no biggie in terms of workload - after all we used to crossmatch everything...

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All though this is a wonderful idea in theory - in practice it could result in the accidental electronic issue of a clinically significant antibody. Take away the failsafe and you risk an error. We insist on full crossmatch for any new or historic antibody regardless of whether it is demonstratable or significant. It's no biggie in terms of workload - after all we used to crossmatch everything...

 

That is exactly what we do! We do not take the risk and crossmatch all historic and new antibodie patients.

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Same as Terri.  As part of antigen/antibody checking, each antibody is classified in our LIS system as Clinically Significant or Not Clinically Significant.  We would never be able to Electronic XM/Electronic Issue to a patient who has a Clinically Significant in History even if the current antibody screen is neg.  If the antibody is classified as "Not Clinically Significant" and the current antibody screen is neg the patien qualifies for Electronic XM/Electronic Issue.  

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