Liz

Please note that when a unit is CMV positive, leuko-reducing it does not change its status; it remains CMV positive.

I want to add that I agree with Adiecast.

Hi I see my name Pre-storage leukocyte reduction, reduces the WBCs, they are not depleted. The filtered unit is called CMV-safe. As safe as if we serologically tested the unit and it tested negative (Ab). If your oncology patient is CMV negative I would give CMV serologically negative blood (it is required to test the unit) and, if possible, preferably by NAT, as well as pre-storage leukocyte-reduced through filtration. The pre-storage leukocyte-reduced through filtration will be for CMV and for the other benefits of leukocyte-reduction.

But the immune system is already tolerant to the A1 as it would be in utero if it see it's (non-identical) twin's Blood group. What I am trying to say is that the RBCs don't have to keep expressing the A1 for the immune system to remain tolerant to it, or do they? As i see by your post Malcolm it is possible, so my question should is: what is the mechanism for this loss of "tolerance" ? How does the immune system "unlearn" what it once learnt?

Hello kenvinlee89 welcome. Whats up with the Kung fu panda signature?

Shannon, welcome to this forum. They should not leave you alone until you tell them that you are comfortable.

oh my its an open book exam......

If it is an anti-A1 are you sggesting that initially the patient is (was) A2?

I would like to help too, I would not mind a cookie!! But I too am over the pond and beyond!! so I'll just help without a cookie

Partial results were good: we initially had a 3+ AbSc, 3+ panel and 3+ AC. I performed the commercial PeG auto adsorption with egaual volumes of Serum, PeG and patient Cells. 2 adsorptions and the Ab Sc was then negative (pooled cells) and AC was +2. I shall repeat with non pooled cells and shall try with one adsorption. Moreover, the cells were not washed as Dave suggested. I performed the AbSc with the adsorbed serum/PeG on the gel cards. This is a disadvantage because of the the serum/PeG to cells ratio. So I shall repeat by the tube method in order to have a 4:1 serum/PeG to cells ratio. Am I on the right track?

Please tell us what you released (if you did) and the patient's response (Hct, Hgb). Thank you

Not the wristband, but the label that you print out when you perform a cossmatch.

Thank you. I see. So, if they all (4 or 6 cells with a variety) react and especially the same strength then that is my auto. We are trying this now with a great first sample: AC 3+, AbID all 3+ and Panel all 3+. I'll report back.

Please tell me how to check the adsorbed serum for complete adsorance of the auto antibodies. If I add the patient's cells and perform the AHG test, they are already sensitized so it will be positive in both cases..... Thank you

I was in the US some time ago and saw the pink printed adhesive crossmatch bag labels, that have a duplicate stuck for the patient's chart. We plan to apply this. I cannot find the one I brought back (it has been ages..!) Can I bother someone to scan one for me, please. I need to show it to our IT gentleman. Thank you very much!!!! Do you need my email? ek01@aub.edu.lb Liz

I use CAP's Bacterial Detection in Platelets. Do not know any other.

Oh yes, happy Fourth of July!!!:handshake:handshake:handshake:handshake

Yes there is such a place And you found it Mia, Welcome and good luck!

From Dave's ref 1999 Transfusion, it is the same: No washing. Equal volumes of untreated allogeneic RBCs, serum, and PEG were incubated at 37°C for 15 minutes. Four drops of the harvested serum-PEG mixture (to account for the dilution of the serum by the PEG) were added to 1 drop of 3- to 5-percent RBCs and incubated for 15 minutes at 37°C before the antiglobulin test. When subsequent adsorptions were needed to remove antibody, additional PEG was not added. Question: I can use atuologous cells instead of allo, right? ( of course unless there has been Tx and preg in the last 3 months.)

I am back. By: Use of polyethylene glycol for performing autologous adsorptions Joan Cid, Xavier Ortín, Asunción Pinacho, Rafael Parra, Enric Contreras, and Enric Elies, TRANSFUSION 2005;45:694-697. we use: 1 volume of patient’s RBCs, 1 volume of plasma, and 1 volume of PEG (Immucor). This mixture is incubated for 15 minutes at at 37 C and then centrifuged for 7 minutes at 1000g. We harvest the adsorbed plasma-PEG mixture and test four drops of this mixture with one drop of reagent RBCs, incubated for 15 minutes at 37 C and proceed to the antiglobulin test with anti-immunoglobulin G (IgG). Questions: Is this right? What if I use Polyspecific AHG (IgG + C)? would I be defeating the purpose and if so why? Thank you. Liz

The different Blood groups!!!!!!!!!!! that is a killer. I mean it literally.... the patient will say BUT I know I am of a different Blood Group. What can I say? "the other lab was wrong"........ never !!! those words may bring the other lab manager to his/her last day on earth. So to the next question: Can blood groups change?? I say yes of course!! all the time!! (and I am not 100% lying)..

:juggle::clap::clap:I think so too!!! Welcome Sita!!!!! Dig in deep into the info and variety of threads, it is really impressive and every day I learn more. Amazing!!!!

Dave, thank you for the useful info that I am going to use with my new kit. I have also pulled out the 1999 article. I hope this is the solution to my headache. And that I shall soon be the one answering questions about Peg I shall soon be the expert (false modesty.. )

Not just Dave, of course all responders' responses are very much welcome.

Thank you Malcolm. One for David: how do I calculate the number of autoadsoptions that I need to do with PeG? Thank you