Elution Studies

[applejw]

1. When do you perform an elution? (e.g. all positive DATs, all positive DATS within 3 months of transfusion, IgG positive only)  Positive DAT with anti-IgG if being tested as part of transfusion reaction investigation or antibody identification or at physician's request.  Positive DAT with neonates are called to the provider and eluate is required if no history or Mom has positive antibody screen or there is no ABO incompatibility between baby and Mom
2. What method is utilized for the elution?  EluKit II
3. What method is utilized for testing the eluate?  Gel or modified AHG in tube
4. How is the eluate tested? (e.g. screening cells, full panel, specially selected cells) Full panel unless sample size is limited then perform a selected cell panel
5. Feel free to mention any special notes/criteria for which I may not have though to ask. I prefer gel but sometimes tube is cleaner.  Some of my techs have a problem with anomalous gel results and I think it is due to stroma contamination.

[Joanne P. Scannell]

On ‎4‎/‎11‎/‎2016 at 1:36 PM, Malcolm Needs said:

1.  We will perform an elution with a positive DAT within 3 months of a transfusion, BUT, will also perform elutions on other cases (even if the DAT is negative) if the clinical symptoms give us reasons to suspect that an elution may be of help.  Nothing in the world of blood transfusion is pure black or white.

2.  Normally, we use the acid elution technique, but will, occasionally use the Lui technique.

3.  Usually, but not exclusively, gel IAT.

4.  Full panel, as a minimum, but may include A₁ and/or B cells, and others as required partner's red cells in the case of a suspected case of HDFN due to an antibody directed against a low prevalence antigen).

5.  I can't think of any - YET!!!!!!!!!!!!!!!!

Ditto!

 

More Questions: 

Didn't I read a few years back the the UK reference labs only do elutions within 2 weeks of a transfusion?

What is the rationale for 3 months?  I could never see the reasoning for that (Yes, I know an RBC 'lives' for 120 days but the math for that makes no sense to me.)

[Malcolm Needs ☆]

4 hours ago, JPSCANNELL f. CROKE said:

Ditto!

 

More Questions: 

Didn't I read a few years back the the UK reference labs only do elutions within 2 weeks of a transfusion?

What is the rationale for 3 months?  I could never see the reasoning for that (Yes, I know an RBC 'lives' for 120 days but the math for that makes no sense to me.)

Yes, you are almost right Joanne (my bad) - but neither was it two weeks - it was more like four to six - but certainly NOT three months like I suggested.