NAN47

We in our blood bank have sent away kleihauer positive samples for flow cytometry testing which has come back as negative as the technique looks for 'RhD Antigens' on the foetal red cells, in which case it is likely that the foetal cells are D negative and a negative flow result is returned. 

We in our blood bank have sent away kleihauer positive samples for flow cytometry testing which has come back as negative as the technique looks for 'RhD Antigens' on the foetal red cells, in which case it is likely that the foetal cells are D negative and a negative flow result is returned. 

I think those who do this would put the compatibility label on the back, so that no other labelling is covered up.  The adhesive used should be tested to ensure that the label does not fall off between the temperatures at which the blood is stored or at the temperature at which the blood is transfused (and, in my experience, it is harder to get the labels off than it is to get a senior member of staff to buy a round of drinks!), but you do have to ensure that the adhesive is of a type that does not leech through the plastic into the unit itself (seriously - there are some that do)!

Thanks NAN47.  I'll have a think over the Easter holiday.

Hi Malcolm...it is a district general hospital blood bank, uses Diamed technology. 

Hi gagpinks , i successfully passed the HSD in transfusion in 2010, so if i can be of any help feel free to get in touch!
Currently waiting on my exams results from the HSD in laboratory leadership and management which are released on Friday --eekkk!
 
Thanks
 
Tricia

That is brilliant, thanks very much Malcolm 
 
kind regards
 
Tricia 

PathLabTalk QPathLabTalk Quantification.docxPathLabTalk Quantification.docxuantification.pptx
Hi NAN47, I (hopefully) have attached a short PowerPoint lecture of 14 slides, together with a Word document that explains the various slides.  I hope these help, but, if not, please do not hesitate to get back to me.  If my attachments don't open (or I have failed to attach them in the first place, please Private Message me with an email address, and I will send them to you by that method.
Best wishes,
Malcolm

The weekend shopping wasn't high on my list of things I love doing, to be honest!!!!!!!!!!!!!!!!!!!!!!!!

Aw that's great thanks Malcolm, sounds like a super weekend! Enjoy! 
 
 

likewise Malcolm, always nice to put a face to a name 

I do indeed Tricia, and it was a real pleasure!

Thanks for the responses
Hi Malcolm, not sure if you remember but I spoke to you at Scotblood this year!
 
tricia

Hi Tricia,
It isn't actually that uncommon a phenomenon, and is due to the anti-c being, at least partially, IgM in nature.

Most of the common Rh antibodies have been reported as IgM. A "saline-reactive" anti-E is probably the most often seen. I've personally seen an anti-e that appeared to be IgM.
Way back when, in the dawn of time........there was serious concern over examples of IgM anti-D potentially causing ABO reverse typing discrepancies - hence why the commercial reverse calls are all Rh-.

Hi , we have in the last couple of weeks had two cases of patients with anti-c , reacting with the A cells of the blood group, i have never saw this before ( only the usual cold reacting antibodies such as Anti-M etc)  and was just wondering if this is something that others experience and why this is happening? The supplier has confirmed that the A cells are A neg (rr) cells. 
 
 
Thanks
Tricia 

Thanks Malcolm, I completely agree that assumptions should never be made on such things and I will be sure to raise this issue, so basically what is being said is that if a positive antibody screen is detected at the 28 week screen for anti-D that this should be sent for quantification even if the patient has recently received Anti-D Ig for a sensitising event earlier in the pregnancy?
Thanks for your thoughts

Hi all,
I have been reading over these new guidelines and am interested in people's thoughts on the following paragraph
There have been several cases in the UK where immune anti-D has been mistakenly assumed to be prophylactic without a validated method of measuring the strength of serological reaction or taking into account an accurate history (2010 SHOT Annual Report). It is important therefore that regardless of any prior administration of anti-D Ig, any anti-D detected at 28 weeks should be quantified and the results made available in the woman’s hand-held and hospital records.
At present we do not send patients sample away for quantitation if they have been recently given anti-D and presume that it is prophylactic anti-D that we are detecting, is this a common practice in other hospital blood banks?
Thanks

Not sure exactly what you are asking here, I am a bit unfamiliar with your terms.  The precision of a particular test is usually indicated by the manufacturer.  It can be estimated by looking at the variance at certain levels.  Control results can be used for this and also used to roughly compare methods from site to site.
A more common way to compare different analyzers within the same system is to do a correlation with patient samples.  Also, when a test is first set up, a patient normal range should have been established.   If  you are using different analyzers at different sites, you may have to use different normal ranges.
Hope that helps.  You should be able to get more information form your vendor's technical specialist.
Scott

Have a look on the Westguard Rules website
https://www.westgard.com/clsi-c51.htm
This is a good resource on it
http://www.eurolab.org/documents/EL_11_01_06_387%20Technical%20report%20-%20Guide%20Measurement%20uncertainty.pdf
And a 2012 paper here
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3387884/

Hi Malcolm as far as I am aware it is a proven auto anti-D , but units they are providing are least incompatible , yet rhesus neg units are compatible, I will look into it in more detail tomorrow and speak to reference centre, will post an update....
thanks

Sorry PVP, patient versus plasma auto control.

The different blood group systems, the Weak and Partial D types, AIHA, TRALI, antibody/antigen reactions, serological techniques, prions, etc.  If I can help, give me a private message.

That's a great response thanks Malcolm, and I look forward to reading the updated guidelines, many thanks
Tricia