Antigen Tested Units

[Jane12 24]

Hello All,

I am trying to revise our Blood bank policies and wanted to make some desirable changes in practice. We have been ordering " Antigen Tested Units " from our Blood supplier and have been repeating antigen testing in house to confirm them. I am not sure if we are required to repeat the testing because of regulations? I do not want my staff to repeat the testing. Can someone please enlighten me with details? Thanks in advance for your time.

[Kathyang 33]

  When we order antigen testing, we don't re-test the unit. We do order historically tested units from our blood supplier and then we test it.

[mollyredone 316]

 

2 hours ago, Kathyang said:

When we order antigen testing, we don't re-test the unit. We do order historically tested units from our blood supplier and then we test it.

That's what we do as well.  If the unit comes from the supplier with an antigen test result on a separate tag, we do not retype it.  We also get a historical database from our supplier to test our own units.

[SMILLER 669]

There are two types of "antigen negative" units we can get from our supplier here in Michigan.  One is "historically negative" -- those have to be retested when they arrive.  The other type is "confirmed" -- those units have been confirmed negative for a particular antigen at the supplier and do not need to be retested here.

Scott

[Carrie Easley 77]

48 minutes ago, SMILLER said:

There are two types of "antigen negative" units we can get from our supplier here in Michigan.  One is "historically negative" -- those have to be retested when they arrive.  The other type is "confirmed" -- those units have been confirmed negative for a particular antigen at the supplier and do not need to be retested here.

Scott

Our policy as well.  

[Christy Spence 12]

3 hours ago, SMILLER said:

There are two types of "antigen negative" units we can get from our supplier here in Michigan.  One is "historically negative" -- those have to be retested when they arrive.  The other type is "confirmed" -- those units have been confirmed negative for a particular antigen at the supplier and do not need to be retested here.

Scott

This is our policy as well.

[Jane12 24]

Thanks much for all the information. This Blood Bank community is of immense help & I really value your opinion. I am fairly new at my job as a Lead and counting on you for advice. 

[Baby Banker 33]

We test if the patient already has the antibody.  We've had units come in that were marked one thing but were actually the opposite. 

[Malcolm Needs ★ 3,998]

1 hour ago, Baby Banker said:

We test if the patient already has the antibody.  We've had units come in that were marked one thing but were actually the opposite. 

That is terrible - absolutely unacceptable.

[gagpinks 43]

In UK we don't have to worry about retyping donor unit. Our national blood service give 100% assurance of their testing. 

[MaryPDX 39]

On 11/9/2017 at 7:36 AM, SMILLER said:

There are two types of "antigen negative" units we can get from our supplier here in Michigan.  One is "historically negative" -- those have to be retested when they arrive.  The other type is "confirmed" -- those units have been confirmed negative for a particular antigen at the supplier and do not need to be retested here.

Scott

We do it this way also. 

[Marianne 53]

AABB standard 5.13 states

5.13 Serologic Confirmation of Donor Blood Red Cell Antigen Other Than ABO/Rh Red Blood Cells products labelled as negative for red blood cell antigens other than ABO and RhD do not require repeat testing for the labeled antigens

[SMILLER 669]

10 minutes ago, Marianne said:

AABB standard 5.13 states

5.13 Serologic Confirmation of Donor Blood Red Cell Antigen Other Than ABO/Rh Red Blood Cells products labelled as negative for red blood cell antigens other than ABO and RhD do not require repeat testing for the labeled antigens

The above is interesting, and it is found under Transfusion Services standards.  Under collection facility standards, 5.8.4 says that untested units for "other" antigens may be labeled negative only if units from two previous donations were tested  by the collection facility.  Does anyone get this kind of information from their blood supplier?  We just either get a "confirmed negative" or a "historical negative" label, with the historical label specifically stating that confirmatory testing must  be done.  So I guess we are stuck with that.  Not really much of an issue here though!

Scott

[Teristella 75]

14 minutes ago, SMILLER said:

The above is interesting, and it is found under Transfusion Services standards.  Under collection facility standards, 5.8.4 says that untested units for "other" antigens may be labeled negative only if units from two previous donations were tested  by the collection facility.  Does anyone get this kind of information from their blood supplier?  We just either get a "confirmed negative" or a "historical negative" label, with the historical label specifically stating that confirmatory testing must  be done.  So I guess we are stuck with that.  Not really much of an issue here though!

Scott

Is that collection facility standard referring to the actual product label, and not a hang tag or other type of tag?

[SMILLER 669]

Right.  They also have to include things like expiration date. product code, etc. So between the tag from us and they label already on the unit, I guess it is all covered.

Scott

[BldBnker 30]

We do the antigen testing for units ordered from our blood service.  We have found units that were supposedly negative for an antigen but actually positive.  We also are required by our computer system to enter the antigen testing results for a unit before it will allow the selection of that unit to a patient with the corresponding antibody.  

[AMcCord 1,027]

19 hours ago, BldBnker said:

We do the antigen testing for units ordered from our blood service.  We have found units that were supposedly negative for an antigen but actually positive.  We also are required by our computer system to enter the antigen testing results for a unit before it will allow the selection of that unit to a patient with the corresponding antibody.  

How do you handle those that you don't have antisera for - like Vel for example?

[Malcolm Needs ★ 3,998]

4 hours ago, AMcCord said:

How do you handle those that you don't have antisera for - like Vel for example?

I am glad you asked that AMcCord!  I was going to ask the same, but thought I might be accused of going over the top.  Now I would have felt justified.

[Eagle Eye 199]

On 11/14/2017 at 9:17 AM, Marianne said:

AABB standard 5.13 states

5.13 Serologic Confirmation of Donor Blood Red Cell Antigen Other Than ABO/Rh Red Blood Cells products labelled as negative for red blood cell antigens other than ABO and RhD do not require repeat testing for the labeled antigens

Based on these standard we stoped retyping the units but we have internal process to check the clerical entry by our staff.

[Eagle Eye 199]

On 11/14/2017 at 9:34 AM, SMILLER said:

The above is interesting, and it is found under Transfusion Services standards.  Under collection facility standards, 5.8.4 says that untested units for "other" antigens may be labeled negative only if units from two previous donations were tested  by the collection facility.  Does anyone get this kind of information from their blood supplier?  We just either get a "confirmed negative" or a "historical negative" label, with the historical label specifically stating that confirmatory testing must  be done.  So I guess we are stuck with that.  Not really much of an issue here though!

Scott

This standard is for collection facility and based on these standard BBTS standard was updated and stated that we do not need to retype the unit...

[SMILLER 669]

Right.  But please look at AABB standard 5.8.4.  As I mentioned above, the donor processing facility can only label a unit as tested negative (far a particular antigen) if that has been done on two separate occasions.  In that case, or if the unit in question was tested by the donor facility, the donor facility could indeed label the unit as "negative for RBC antigens".  Otherwise, it would have to be tested, either by the donor facility or when it reaches your blood bank.

After all, every donation by a donor is typed twice for ABO before a patient gets it.

Scott

[Laurie Underwood 33]

Same as Eagle Eye and we just had a patient with Anti-Vel last month. Would not have been able to retest the units sent by our blood supplier.

[BldBnker 30]

We have the ability to program our system to accept "untested" units for selection for antigens that do not have available anti-sera, like Cob, Bga, or Vell etc.   We use SoftBank.  

[Barb Thompson 26]

We don't retest because we do not have the antisera.  So far we have not had any issues.  We only stock Rh, K, FyA and JkA.  

[Gnapplec 13]

On ‎11‎/‎10‎/‎2017 at 12:38 PM, Malcolm Needs said:

That is terrible - absolutely unacceptable.

Yes terrible.  I am hoping this was reported by the FDA by the blood supplier.  Scary.  @Baby Banker This should never happen ever.

Edited January 24 by Gnapplec