cmontgomery

This flow chart is not dedicated to electronic crossmatch but does address it in section B.
ecxm flowchart.docx

I suppose so John, but like Peter Issitt before me (not that I am comparing myself with the great man), I am very keen on the use of correct nomenclature.  Indeed, if my failing old memory serves me well, my first post on this site was all about that subject.

I enjoyed reading it.  Thank you Blut! !
UK is lucky to have him with his wealth of knowledge and he is always on board to reply any time.

Prof. Theirry Burnouf, Prof. Axel Seltsam, Sue Johnson and some English guy ay Cressier in 2015.

Well, reading has always been a hobby, and, at the moment I am making my way through the book by Steven R Pierce and Marion E Reid, Bloody Brilliant!  A History of Blood Groups and Blood Groupers. (and it really is "Bloody Brilliant too) and reading about all the "names" who I have been fortunate to meet and/or work with.

Thanks to a very generous invitation from the organisers (in particular Phil Hoffman, aka Dr Pepper on this site, and Maddie Josephs, Chair) I will be attending and speaking at the 69th Annual Clinical Laboratory Science Convention - Central New England (ASCLS - CNE) taking place at the Rhode Island Convention Center between May 9th and May 11th 2017.  I will be talking on Wednesday 10th May 2017, giving a lecture entitled, "An In Depth Description of the Kell Blood Group System." and then, after a well-deserved break for the delegates, and for those that can stand it, a second lecture entitled, "King Henry Viii, McLeod Syndrome, Chronic Granulomatous Disease and Kx."
Sorry if this comes across as being "big headed", but I am really excited about coming back over to the USA.    

We have been told not to use the Ortho Panels (or Reagents) with Grifols GEL Cards....you can get erroneous results.  We have also always used the Immucor Panel (and apparently that is ok for Grifols GEL), and Grifols has just come out with a 2nd panel. They asked my opinion of the cells on the panels and I honestly told them I was not excited about the panels (not enough homozygous cells; NO K homozygous cell; etc.).  I have also requested that they designate cells on one of their 2 panels that can be used as a modified panel for Passive D (as both Ortho and Immucor do).  They are working on all of these issues.  What is good about Grifols is that they are very open to suggestions and recommendations for improvement and seem to be quick to act upon them.  So speak up to your Grifols Rep!
Brenda Hutson, MT(ASCP)SBB

Congratulations Malcolm, you have retired alive and the future is all yours!  Thank you for your contributions and for any future and wonderful advice.

Congratulations Malcolm, you have retired alive and the future is all yours!  Thank you for your contributions and for any future and wonderful advice.

With the test results you obtained, I think that you were correct in not sending it to a Reference Laboratory - the people who work there are not magicians, and would just be confirming your findings - expensively!  As long as the units were actually tested and found to be Jk(a-b+), and not just found to be cross-match compatible, you were good to go in my opinion.

Well, that's me finished.  I am officially retired from work - but not from this wonderful site!

Congratulations Malcolm, you have retired alive and the future is all yours!  Thank you for your contributions and for any future and wonderful advice.

We are also analyzer shopping, and I found that the data provided by the company should only be taken w/ a grain of salt.  Some companies start the timer when the tube leaves the tech's hand, while others start at the beginning of pipetting (negating all of the sample & reagent identification steps).  Most of the ones we have looked at are within a few minutes of one another.  Some of my biggest motivators were a manual back-up method using same methodology, random access, the ability to run infant specimens, phenotyping capabilities, on-board reagent storage, and quality reagent cells.  We are moving forward with the Erytra by Grifols (currently have a ProVue).

We have had 2 ProVue's but are now in the process of purchasing the Erytra.  Just liked the features and equipment better (Vision was also pretty loud). We will only be purchasing 1 Erytra, but will also get the Manual Workstation and DG Reader which will also be interfaced with our computer system.  Barring any "long" downtimes by the Erytra, we can handle our workload with 1.    I will be going to training in Sept. and that is when the machine will be brought in "and the fun will begin....."
Brenda Hutson, MT(ASCP)SBB

I agree with Mabel's assessment. I am in the market to replace my Provue and my preference is the Erytra. The main downfall is that the Erytra is not a tabletop analyzer so space is a concern. Also, the capital expenditure is greater than for the Vision. I love that the Erytra is true random access. The Erytra's capacity is greater and the time to process is slightly faster. 
Although I was impressed with the Bio-Rad IH1000, that analyzer is HUGE and as far as I know, it's not FDA cleared yet. 
One of the reasons that I'm looking to switch vendors is that I feel that Ortho's customer service has deteriorated substantially over the past 2 years. Additionally, whereas Grifols manufacturers the Erytra and Wadiana, Ortho contracted Grifols to make the Provue (it's actually a Wadiana under a different name) and the Tecan to make the Vision.

We have two hospitals using the Erytra. send me a pm and I will give you contacts. We are also using the Wadiana and the DG Reader.

I think those who are in the market for automated blood bank analyzers also need to look at what Bio-Rad is coming out with. I think both their Gel and solid phase automation platforms should be compared to the other vendor products.

We have looked at both pretty extensively.  I preferred the Erytra mainly because I think that their gel wouldn't pick up as many false positives as Ortho's.  There are more "bells and whistles" on the Vision so evaluate how they fit your needs. I am not ready to run gel titers so that is not a great value to me, especially because it would use up a lot of reagent cells when it runs, I think, 12 dilutions on every titer.  Maybe there will be a software fix later that will let you run fewer dilutions.  Grifols is still getting reagents released in the US so they don't have everything you might want yet.  Last I heard they have only a single 0.8% panel through approval.  If you will use the instrument for your high throughput testing and do follow up testing manually, that is fine.  If you want to put panels A,B,C and Ficin on the machine, you will have to wait a while for Grifols, although the Vision can do this (pay attention to onboard stability times).  Examine how the specimens and reagents are accessed in each machine (carousel vs. slide-in racks) and think if that will make any difference in your operation. It might be different for generalists who pop into BB to run something on nights than for a fully 24/7 staffed BB. Be sure to get the vendors to help you with site visits so you can see them in operation and talk to real users. We were also allowed to have a manual workstation for a week so we could run comparison gel testing in both manual systems. We found that helpful.

I have recently done an oral presentation about our research project on anti-CD38(Daratumumab) during this recent AABB meeting in Anaheim. I have some abstract references that I have attached here. Hope it helps. 
Also a full article here. http://onlinelibrary.wiley.com/doi/10.1111/trf.13069/full
3 of 8 patients(i have seen to date) has positive DAT and 2 of them were on IVIG. We found that this antibody is non-reactive with In(Lu) cells by tube method. By tube method, DTT treated cells were non reactive, cord cells were weakly reactive to non-reactive.(not enough cord cells were tested yet to find pattern) 
Our flow cytometry data wiith florusecnt labeled anti-CD38 shows that DTT treated cells has very low percentage of CD38 (2%-4%), cord cells has about 21%-24% and positive control varies from (53-82%), In(Lu) cells has about >20%. These data were presented orally during AABB meeting but not yet been published. 
 
SKMBT_75115100213120.pdf
NEJM Aug 2015 editorial on Dara.pdf
cord rule out.pdf
abstract-ARC and NYBC.pdf
abstract-ARC and NYBC.pdf

Terri, to my knowledge PSB and powdered DTT are the only options at this time. There is buzz in the reagent community about manufacturing this reconstituted for resale. Sigma Aldrich does sell the powder form. You can go on their website and find the info or contact one of their engineers. They are very helpful.

It is the prerogative of anyone on this site to disagree with anything I may say, but I was once involved in just such a case.  It involved an 8-year-old D Negative female, who underwent exchange transfusion and cover with anti-D immunoglobulin, following a massive transfusion of D Positive blood.  She was followed for many months afterwards, but allo-anti-D was never detected in her circulation.

I will be at AABB, any plans to informally meet each other from this website?

I will be at AABB, any plans to informally meet each other from this website?

Well, Malcolm, we would get the same results on a 2nd type so it wouldn't help an Oh baby any having done it twice, would it?  If a neonate was Bombay (Oh) we couldn't tell the difference from an O, right? Since we do the antibody screen on the mom, we would assume the baby is group O and use O blood like usual.  Would they have much anti-H yet so their own antibody screen would be positive?  Will they have a transfusion reaction?  How might this play out over the course of their NICU stay?
 
The odds of this are really low here but I am curious.

You couldn't tell the difference Mabel - hence the devilish emoticon!