LAURIE

Thanks everyone for their input...gave us some things to try....let us know if anything else comes to mind and I will let you know how we make out...

Mechanical damage has been ruled out. After the first reaction discussed with transfusionist; only saline. will try serum with AHG...thanks

well, we found out after the first hemolytic reaction ( that is after seven units in seven weeks), she had experienced hemoglobinuria at home after she received two units same day (#4 and #5) week 6...so much for outpatient instructions post transfusion. medication list seems innocuous...something for pain, vertigo, anxiety and nausea

*She is not a small stature women: 179 lbs 5"2" * No particular rationale for giving washed cells * I would say all units given from a cold environment except when blood warmer used; reference lab ruled out over thermal range of 4-37C * All samples are EDTA...next visit I shall request both EDTA and clotted sample for evaluation She seems to tolerate single unit transfusions best, but why? nothing particularly significant with medication history...just want a reason!!

Anemia! Thats all we get

Elderly female, Group O Positive with a negative antibody screen received three single unit (OPOS) leuko-reduced red cell transfusions two weeks apart with no untoward effects. One week after last single unit transfusion, received two units (OPOS)on an outpatient basis and was discharged. One week later, received two units (OPOS) and experienced a febrile reaction with hemoglobinuria; she was admitted for a transfusion reaction workup. Post reaction sample was hemolyzed with a negative antibody screen and negative DAT. Full crossmatches performed with pre and post samples were compatible. Eluate was negative. Sample drawn immediately after(#1) reaction and one 24 hours post(#2) was referred to reference laboratory. Sample #1 acid eluate demonstrated Anti-D in saline; microscopic to weak positive with all cells in PEG, showing no specificity, unable to determine if anti-D is allo-or autoantibody. Serum hemolysis resolved in 24 hours. One week later admitted and transfused with two units ONEG leukoreduced red cells and again experienced a febrile hemolytic episode; DAT pre and post negative-hemolysis resolves in 24 hours. Two days later receives one unit (ONEG) washed red cells; no reaction or hemolysis. Next day, receives one unit (ONEG) washed red cells and experiences hemoglobinuria and post sample hemolyzed; again DAT negative. Finally, one week later, receives one unit (ONEG) washed red cells thru the blood warmer with no post hemoglobinuria or serum hemolysis.HELP!

For those of you who have evaluated and subsequently gone with automation, what criteria swayed you to one instrument or the other? Any problems encountered? All insight would be greatly appreciated! We are currently looking at the Provue and Echo...we are gel system users right now and very comfortable with it.