sgoertzen

At my institution. the Donor Network is now asking for 4-6 units of RBCs for organ perfusion for their machine after the organ has been harvested (similar to ECMO for the organ).  Those RBC units will not ever touch the organ donor patient.  Our policy is to always issue them the oldest O Pos units (uncrossmatched) we have on our shelf.  They will rinse all of this banked blood out of the organ before transplanting it into the recipient, and it is added to the perfusate solution to provide oxygenation to the organ during transport from the donor hospital to the recipient hospital.  AABB offered at least 1 very informative session at their annual meeting on this last year in Nashville, and I'm guessing that they will offer more in Houston this year (or perhaps an eCast session or articles in AABB News or Transfusion) since this practice is becoming more and more widespread. The unique nature of the process is proving to be a challenge for hospital transfusion services as far as who places the order, what testing is needed (if any), tracking for final disposition, what kind of records need to be kept because they are not being "transfused", billing of the products, etc..

This is also our policy. If the cold antibody is so strong (3+ to 4+) that we must use pre-warm tube testing in order to do the workup, we advise them to use a blood warmer regardless of the location where the transfusion is being given. 

I work at a children's hospital and we use WellSky and Epic/Beaker.  We built an orderable test called "Isohemagglutinin Test and Titer" specifically for reporting out the presence and strength of Anti-A and Anti-B.  This test is not affiliated in any way with the regular patient Blood Type test.  It's mainly ordered at my facility to monitor and follow patients with immune deficiencies or who have had an ABO mis-matched bone marrow or stem cell transplant, but it sounds like it would also meet your needs with heart transplants.  I've attached our procedure and worksheet.  This is how the results display in Epic.  If you're interested in building something like this, I can put you in contact with our WellSky & Beaker IT gurus who built this for us.  My contact is sgoertzen@valleychildrens.org 
 

TO-310 Isohemagglutinin Workup - Test and Titer__uncontrolled_copy (1).pdf TO-310F01 Isohemagglutinin Test and Titer Worksheet__blank_copy_id_7905995.pdf