dcubed

Field engineer was here last week. Adjusted camera and rebuilt the gripper. Problem solved.

Brenda, we also have seen quite a few "?" on the A1 well. It is getting to be a real pain to have to look at all of these. Also, I am afraid that techs will get complacent and will assume that "it's just the A1 cell acting up again" and not really take a good look at the well. Just a PM done a couple of weeks ago....may be related???? Anyway I will be calling service today. Brenda, have you seen more "?" on the B cell when the patient is type B?

Ran controls from this kit today. The positive control for us gave a positive result.

We did a KB stain.

We have a baby that types as D pos, 3+ in gel. We recheck ABD in tubes, this baby did not react with anti D until the AHG phase of testing. Mom is D negative. Should we just skip the rosette test for FMH and go staight to a quantitative test, ie KB stain in our case?

Is anti A1 made by an Aintermidiate indivual clinically significant? My suspicion is that it is not, but I can't find a lot of information about this. Has anyone successfully given "random" type A units to this type of patients? Thanks in advance for your input.

Pre delivery screen on Mom= O Neg with a negative IAT(confirmed with a repeat on another sample). Baby= A Neg, DAT=Neg(with anti IgG), IAT=Pos on baby, D neg screen cells from panel=neg. It is presumed that that pos IAT on the baby is from antenatal RhIG that was given to Mom, but why is Mom's IAT negative?

Thanks to all for the input. We have had 3 such patients in the past couple of weeks. Maybe the backtype cells we are using have a particularly strong M expression.

We played around with the bubble or no bubble with some samples that were showing weak antibody reactivity and saw no significant difference.

When a reverse group does not agree with the forward type due to a cold reactive antibody, such as anti M, is it required to find A1 and B cells that lack the antigen and repeat the reverse grouping with those cells?

Thanks Malcolm, The jury is still out on this one. Our Ref lab is doing molecular antigen typing, hopefully this will help?

I wonder if patient got more than 1 injection of Rhig? You did the right thing by giving a dose of Rhig postpartum. When in doubt, give the Rhig.

We have a patient that came to us 36 weeks pregnant. She moved to our area from another part of the country. She alerted the nursing staff of "problems" with her blood. We called the hospital that had seen her before and they reported that her sample had been sent to a reference lab with anti hrs and anti big E being identified and that the patient was probably a partial D. We sent her samples to our reference lab and they are saying that they think we are dealing with an anti Hro (their workup is not complete at this time). My question is what are the odds of finding compatible blood for mom or baby if needed? Should we consider having Mom donate blood that can be given to baby if needed? Any helpful comments will be appreciated.

When you have two bags of red cells from the same donation and they have they same unit number, is it necessary to antigen type segments from each bag or if one part is typed can you just make the presumption that the other bag should type the same way? I think I know what the answer is, but I just want to throw this out and see what I get.:cool:

Thanks to everyone for the info. I have a vendor that is trying really hard to sell us a secondary wrist band system.

Has anyone heard about a fairly new standard by the Joint Commision about all blood bank samples needing to have a secondary identifer in addition the the "standard" hospital labels?

Thank you Damien. We received the charts requested from you and have them framed and up on the wall. They are quite nice!

A brief synopsis of what happened here: Lady was given three dose of Cefatetan post op as prophalaxis. Released from hospital with 13.6 gram hemoglobin. Three weeks post op patient presented with a 5.6 gram hemoglobin with a 4+ pos DAT by IgG, 2+ pos DAT with anti c3b-c3d. The pre op speciment had a negative DAT. The patient's IAT has been negative on both admissions. To me this is enough evidence to implicate Cefatetan as the culprit, but the patient's doc insisted that we send samples to our reference lab to look for antibody to Cefatetan, which we did. The reference lab did find antibody to Cefatetan. We have had one other case about a year ago that we also believe was anemia due to antibody to Cefatetan. I for one, would not like to receive this drug!

How many have seen antibody to Cefatetan causing hemolysis in a patient? To what lengths must a transfusion service go to demonstrate the presence or absence of Cefotatan antibody?

I'm thinking that you can get away with this because the baby is not yet immunocompetent. By the time the baby is ready to start making ABO antibodies the cells given during intra uterine transfusion will have, for the most part "died of old age".

We do the FMH screen in the blood bank. If the FMH is positive we take the sample to hematology where they do the KB stain. BTW David S, the fetaldex is a kit for doing KB stain, sickledex is for HgbS screen

If the units are historically negative, your blood supplier should comfirm those typings. We do not routinely check their typings. If the supplied unit(s) were not compatible, then we would check the typings in our lab.

Consider to following scenario: Staight forward antibody ID on patient is anti K, anti C and anti Jkb. Patient has not been transfused in the past 3 months. Auto control on the patient is 1+ positive. Does the auto control need to be investigated? If so what further testing should be done? Thanks in advance.

We used to do them many years ago. They are now done by nursing staff in the outpatient procedure/infusion clinic. Would be nice if we could still do them. It is good to see "real" patients sometimes and not just tubes of blood. Also a good way to promote to the public the "faceless" laboratory scientists.

How do you manage a patient that has anti Kna? Do you give "incompatible" units? Do you crossmatch however many units it takes to find "compatible" units? How do you make sure that the anti Kna is not masking other more significant allo antibody(ies)?