madhu

Hi! Tim, True...a beautiful country and very nice people.I have been there only once but do have a few friends there. Hopefully things will be better from now on...for them as well every one else. As for cricket...u win some u lose some. sri Lanka is quite a good team themselves and unfortunately, Oz has been in the news lately for all d wrong things. Again, I hope they will change for the better. Oh, by the way, I did copy your golden rules and made a colourful poster of it...blue, pink, yellow..grey.... Even though I no longer work in a blood bank, I intend to pin a copy of it on my desk pin board and will pass it on to all blood bankers who would like to have it. Wish u luck. madhu

Hi...Welcome to the neighbourhood.I hope all goes well while you are here.

And another version of murphy's law...YOU WILL ALWAYS FIND MORE PATIENTS NEEDING BLOOD OF THE GROUP WHICH IS IN SHORT SUPPLY AT THE MOMENT...

Hi! Just thought of an amendment...PUT THE RIGHT BLOOD INTO THE RIGHT PATIENT..

OOps...I was trying not to be obvious that i work with the vendor but I had not read all the previous posts;)...so Anna and I do belong to the same team and yes, we do process the samples received. But if I am not mistaken, the numbers in the study mentioning the missed antibodies on the panel, these were never further investigated to determine their clinical significance. Without being biased;) towards our own products, I have to repeat what I said...we need to have a really in depth study of the antigen prevalence in our country - for the commonly known antigens first and then the rare ones, simply because we not only have a huge population but a very diverse gene pool being carried forward especially with the social structure of marraiges within communities n all. Leave aside Indians being exposed to Caucasion donations, we have a major difference even in the different zones in our own country. As noted by me during the various interactions with the users of the gel, I have noticed a very significant difference in the percentage of 'incompatible ANG cross matches' or positive ab screen in the South and North of India too.

As of now we have no definite data on the prevalence of the already 'known' or the commonly found antigens on available cell panels, in our country, leave aside the unknown or the rare ones.So what you may detect in your bloodbank has probably been 'missed' by the other blood bank where the patient received his previous transfusions. Keeping in mind the diversity of the testing done in blood banks in India - ranging from a ABO/D group + saline cross match only at one end to the other end of those institutes performing an AHG cross match, and some doing the whole lot of ab screen and AHG cross match, it would be advisable to perform both - AB screen and the AHG cross match for patients in India. Also bearing in mind that in India, as you have put it yourself, few people are aware of the subject of Immunohematology in details to also undersatnd its repercussions. So you actually do not know what the patient has been transfused till you receive their sample. I work with a manufacturer of the specialised reagents and we have a small reference laboratory as part of our technical support to our customers.In so many years I have processed samples and seen antibodies- single and multiple - in so many cases which shouldn't have been there had we been practising the basics.Most common to the rare ones have been detected in the lab - including an anti-Kpb to some rare blood groups antigens too.

Since the patient is no longer reachable, I can only tell what I received from the hospital - No drug history was received. Elution- I did a cold acid elution. Were Anti-C and Anti-E excluded- yes- used an extended panel of D Neg cells. No previous history of transfusion as informed by the hospital..... I cannot do much on his sample now but it has always baffled me...Can I confirm it as an auto-Anti-D? if not then how do i explain his reactions??? Again, he was transfused with D neg cells without event...

No answers,,,in fact a query of my own. I had a patient..a 34 year old male, admitted with fever, jaundice and anaemia, Blood group O Pos, the D antigen confirmed by use of 2 different anti-D's. His auto control and DAT were positive and serum sample showed antibody identified as anti-D. the eluate also gave the pattern of anti-D clearly. All D neg cells were negative.All these tests were done by gel.His DAT with monospecific AHG was positive only with IgG. The only units compatible for him were O neg and he was transfused with these without any event....does this confirm an auto anti-D??????.

Hi I have been working for the last 18 years through tube technique and gel. One thing all of us have to be open minded about - no system can be 100 % fool proof for everything. We deal with biological reagents for human samples- it is not possible to have 'everything' rolled into one. So choose your own pros n cons BUT yess, gel does make life easier, definitely.

This is in reply to Liz's query if anyone has seen a clear cut negative in weak D on gel...yes, I have and I too use DiaMed gel. I have had many samples for weak D ranging between a weak to 1+/2+ on direct testing with anti-D and a 3 to 4+ with Du test on gel. One case was a clear cut negative with 2 different anti-D's on gel cards but a good strong 3+ on Du test using the AHG IgG card and the special anti-D for D weak testing.

Hello! Everyone. I am usually a 'reader' not a 'poster'. Its interesting to read all exchanges. I agree with Shily. A lot of countries do not screen donors for irregular abs yet. So minor cross matches are routinely done. I am in India and it is only the latest current guidelines issued out that have made mandatory, ab screen for donors & elimination of minor cross matches for us, now. It will be some time until all blood banks get into the routine.

Hi! I am Madhu, from New Delhi, India. A little about myself – my work exp is about 18yrs thru various departments of the lab – Microbilogy, Haematology, Mol biology(PCRs), EIAs, biochemistry and finally, a total of abt 9 years of blood banking in India and Oman. I am now working as Technical Support in New Delhi for multinational manufacturing blood bank products. I came across this forum through a friend. Its been a huge learning process just to read thru the various posts for all these days. In India, though we do have a long way to go before we can say we are up to the best standards, the positive part is the rapid pace at which we are heading towards it. A lot yet to be achieved and any kind of advice, suggestions, help would be welcome towards it. I hope I too can post my ‘problem cases’ I come across, as I try to resolve them for our blood banks in my company’s lab, as part of the technical support we offer?