Rh confirmation of Rh Negative Units

[mld123]

New Supervisor here and new to the site.  I took over a Blood Bank recently where the previous supervisor was there a long time.  They are performing Anti-D typing on their Rh Negative units by incubating the Anti-D tube at 37 C for 15 minutes and then spinning and reading.  I have never done this in the 25 years I have been working in the Blood Bank.  Do you see any reason to continue this practice? 

 

mld123

[goodchild]

The AABB standards specifically address this under 5.12 "Confirmatory testing for weak D is not required."

[Malcolm Needs ☆]

The AABB standards specifically address this under 5.12 "Confirmatory testing for weak D is not required."

 

Really goodchild?  I think mld123 is talking about donor units, rather than recipients, and I would be simply amazed if this was not mandated.  In the UK, we almost go to the nth degree to make sure our D Negative donors really are D Negative.

[Malcolm Needs ☆]

By the way, welcome to this fantastic site mld123; you'll love it!

[goodchild]

Really goodchild?  I think mld123 is talking about donor units, rather than recipients, and I would be simply amazed if this was not mandated.  In the UK, we almost go to the nth degree to make sure our D Negative donors really are D Negative.

 

We're referring to the second serological type (or possibly the third, since my understanding is many blood suppliers do double checks already) but yes.

[mollyredone]

I didn't read anything about washing and using IgG.  Just incubating at 37 C and then spinning.  We don't do that.  We just do immediate spin on Rh-negative units that we receive.  We are not required to do weak D testing.

[SMW]

New Supervisor here and new to the site.  I took over a Blood Bank recently where the previous supervisor was there a long time.  They are performing Anti-D typing on their Rh Negative units by incubating the Anti-D tube at 37 C for 15 minutes and then spinning and reading.  I have never done this in the 25 years I have been working in the Blood Bank.  Do you see any reason to continue this practice? 

 

mld123

 What does the manufacturer's directions for the anti-D reagent in use say to do?

[Malcolm Needs ☆]

We're referring to the second serological type (or possibly the third, since my understanding is many blood suppliers do double checks already) but yes.

 

Oh right.  Sorry!

[mld123]

Thanks for the welcome and your responses.  

 

No washing or adding IgG in the procedure from the previous supervisor.  The whole thing just seems weird to me and I am going to change it back to Anti-D at immediate spin only.  

 

Thanks again!!

[tricore]

"Just incubating at 37 C and then spinning"

 

Many, many years ago we had some not very good anti-D reagent. Our theory was that all of the "good" anti-D was going for RHIG production.  It did not always react at immediate spin but if you incubated at 37C and then spun it, it worked. I hope the SOP isn't that old!

 

The negatives after 37C were always washed and tested with AHG.

Edited December 4, 2015 by tricore

[Bayou]

On ‎12‎/‎4‎/‎2015 at 1:12 PM, mld123 said:

Thanks for the welcome and your responses.  

 

No washing or adding IgG in the procedure from the previous supervisor.  The whole thing just seems weird to me and I am going to change it back to Anti-D at immediate spin only.  

 

Thanks again!!

Yup, Just go with whatever the package insert says. No weak D required.

[seraph44]

We only perform the immediate spin test for confirmation of our incoming Rh negative units.