JOANBALONE

In China, do you routinely transfuse packed cells or whole blood?

We issue units in the LIS in the blood bank. We tube or transport via cooler to the OR. The nursing personnel place units in the OR refrigerator. There is no requirement that you must read back or issue with the person picking up/accepting the blood.

Hi Malcolm, I can't find your protest letter online. Can you post a copy here please?

Hi yaya, If the patient urgently requires blood and the antibody screen is negative you could safely give group O. How much additional testing you can do is dependent on what type of reagents you have on hand. Personally, if the patient does not require blood I may not do any further testing and communicate with the patient's physician that she is probably group O and would ask the physician if he would like additional testing to determine blood group.

You can try 4 drops plasma and immediate spin technique or a room temp incubation with A1, B, O and autocontrol cells. JB

How long do you continue to do AHG crossmatches, until the next screen is negative? JB

I don't think testing A2 cells will solve this problem. I think the most likely explanation is a weak isoagglutinin due to patient age or diagnosis. How much testing do you want to do? You can increase serum/cell ratio, increase incubation time or test reverse at cooler temperatures or you can just give group O red cells. JB

From the circular of info: Transfusion should be started before component expiration and completed within 4 hours. JB

Hi Donna, Do you have a reference for 4 hours from time of issue from Circular of Information, FDA or AABB? JB

You can put a statement in your procedure that says "patient information may be handwritten on the label if time allows". JB

Does your policy allow the use of select cells after the initial antibody id?

I am not sure what a prewarm DAT is. Perhaps the saline control of the DAT was positive and cells were washed several times with warm saline before a repeat DAT was performed. I would call the testing laboratory and ask questions. In my opinion, if initial testing saline control was negative and PS, IgG and C3 were positive I would report a positive DAT. As khalidm3 mentioned above, perhaps elution testing should be performed.

Hi khalidm3, Do you routinely perform AHG crossmatches on all patients? JB

Perhaps I misunderstood, once the initial type on the current sample is complete we do not repeat the sample ABO/Rh when additional units are requested that require serological crossmatch. We require 2 complete ABO/Rh types from different draw times on file before type specific blood is issued. The blood type (forward type) of red cell units received from the blood supplier are reconfirmed before issue. JB

We do not reconfirm either the forward or reverse. JB

Windows

I would have no problem with giving E negative, AHG compatible red cells for transfusion. K is ruled out in my opinion. I would not worry about N. JB

Hi Marina, What does the manufacturer recommend? We do not move the thermometer. No regulation that I am aware of suggests moving the thermometer around. JB

For the incompatible major crossmatch 1. ABO discrepancy 2. Antibody showing dosage such as Jkb. 3. ??

What does your weak D procedure say? We do not read weak D under the microscope per procedure. JB

Hi again velliot, We stopped requiring patient retypes in gel when units were added on to an order. It just took too long. JB

Hi velliot, My Ortho IFU for A/B/D Monoclonal and reverse card and A/B/D card says that EDTA samples should be tested within 14 days (key word 'should').

I like David's theory. It would be easy to test this theory in the lab. JB

Hi BBTers Found this when surfing: http://www.cbbsweb.org/enf/2003/urgenttxaboincompat.html JB

Sometimes the irradiator may malfunction during a cycle (or someone forgets to put a RadSure on a unit). We complete an error report and will use the unit for someone who does not require irradiation.