Walter

Have you found a good alternative pipette for the Ortho Gel system other than the Ortho approved Biohit pipette? If so, what make, model, and programming do you use. Walter

Do you use the Buffered Gel card for immediate spin crossmatch [instead of tube]? If so, what hospital/lab group are you from. Doing research for our technical advisory team. Thanks, Walter

Do you keep and use outdated red cell panels? If so, for what purpose? If used for antibody identification [in addition to in-date red cell panels], do you perform quality control on the outdated panel cells? If you perform QC on outdated panels when used, what QC do you perform? Walter

Does anyone set and do a low alarm test on their plasma thawer? The argument for setting a low alarm [alarm sounds if the temp drops below 30C] is that regulations state frozen plasma components must be thawed between 30 and 37C.

A poll for those in hospital Transfusion Services: Do you restrict Transfusion Service work to Medical Technologists baccalaureate degree) only? If yes, please state your reason for the restriction.

I have seen and experienced weakened reactions in MTS gel tests when I have pipetted cell and plasma straight down into the chamber with the Biohit pipette. Try this experiment: Center the tip of the pipette in the chamber opening. Pipet screening cells vertically into a gel tube chamber with enough force to eliminate the air-gap over the gel. Then, in the same manner, pipette QC material (dilute anti-D or other dilute antibody) into the cells. Do the same in the adjacent gel tube pipetting at and angle, preserving the air-gap. Mark each tube accordingly. Continue setting up tubes until two cards have been prepared. Incubate, spin and compare reactions. Walter

I don't work at the blood center, so I don't have firsthand knowledge of their practice. When I worked at Community Blood Center in Appleton, Wisconsin, we QC'd our individual units of cryo by testing pools of 4 units. This practice satisfied both AABB and FDA regulations.

We use Ortho/MTS gel system for antibody screens, panels, AHG crossmatch. That takes care of scoping. We still scope tube DATs - adult broad-spectrum Coombs. Cord DATs (anti-IgG) are agglutination viewer only. Fetalscreens are scoped per package insert. It is way too easy to overread non-reactions with a microscope. Red cells can look like they are agglutinated if not fully resuspended before viewing. If you use plasma instead of serum the increased protein can enhance rouleaux. Sometimes it is difficult to differentiate rouleaux from true agglutination under the scope. The novice general Med Tech (or the OCD Med Tech) tend to see two or three red cells "holding hands" under the scope and call this a W+micro reaction. I prefer test systems that maximize ab-ag reactions with clearcut macro reading endpoints, e.g. gel, PEG.

The Blood Center of Southeastern Wisconsin (soon to be the Blood Center of Wisconsin) has been preparing pooled cryo for years. They prepare pools of 5 units each, but also make pools of other sizes for certain customers. As far as I know, the pooled cryo isn't licensed, so the products remain in Wisconsin.

Start with a literature search of instances where passive transfer of red cell or white cell or platelet antibody caused harm to a neonate. Journal articles go a long way with pathologists. You won't have a convincing physical argument until you transfuse CPDA-1 red cells from a donor with a high titer, hemolytic anti-A,B.

1. Albumin - Pharmacy 2. Clotting Factor concentrates - Pharmacy 3. Rh Immune Globulin-intramusular - Blood Bank 4. Rh Immube Globulin-intravenous (WinRho) - Pharmacy 5. IVIg - Pharmacy