How many transfusion services are still performing LUI elutions on cord bloods with postive IGG AHG and an ABO discrepancy between mom and baby? Does the result of the LUI really make a difference to the physician concerning treatment of the baby? If not, why are we performing this test?

Also should the LUI be done on cords that have a negative IGG AHG and an ABO discrepancy? Our pediatrians will order this when they suspect an ABO HDN. However, again the question is, does the answer change the treatment of the baby - if not, why are we performing this test?

We stopped doing (heat) elutions on babies of apparent ABO hdn a few years ago. There are still some instances we will perform them: if specifically requested; if the mother has an antibody; or if the baby needs transfusion. We put a comment on the positive dat result, "Probable ABO incompatibility". It seems to be working just fine for us. It is especially nice when it's a busy weekend and there are just a few techs on!

I've always liked the Lui eluate for ABO HDN, since everyone already has a freezer and it's a simple method that even a weekend/midnight shifter could do.

We only do them on request. If the baby is ABO-incompatible with an Group O mom, we assume that we'll find something, but it doesn't always correlate well with the baby's clinical condition.

We haven't done Liu for ABO HDN in years. We do the same as Cathy - "Probable ABO Incompatibility". I still have the procedure in my manual though. Just in case......

We do what ever is asked.

Cord blood work ups (type and DAT) are done at my facility for ALL Rh negative moms and mothers that are type O.

Any positive DAT reaction would have a LUI performed (if ABO incompatibility is questioned) or an acid elution (for other antibodies).

We do what ever is asked.

Cord blood work ups (type and DAT) are done at my facility for ALL Rh negative moms and mothers that are type O.

Any positive DAT reaction would have a LUI performed (if ABO incompatibility is questioned) or an acid elution (for other antibodies).

QUESTION:

Do you know if your pediatricians actually use this information to determine the treatment of the infant or do they treat according to symptoms?

QUESTION:

Do you know if your pediatricians actually use this information to determine the treatment of the infant or do they treat according to symptoms?

I believe they would treat for symptoms,

but our results would give them pause to look harder for those symptoms.

Lui loo eye ... oh, baby! Me wan go ... oh, oh, oh, oh!

I haven't done a Lui-freeze since 1992. If we need to know about ABO HDN, we just do an acid eluate and test the eluate against A cells or B cells, depending upon the baby's blood type. I teach it to MT students, but they don't have to actually perform the test.

BC

The Lui technique is a total waste of time for routine cord blood testing. If the baby has a positive DAT and the mother has a negative screen, and the ABO of mom and baby is such that ABO Incompatibility is possible, then that's the answer: we report the strength of the DAT and add a coded comment "probable ABO incompatibility". We have done this since 1991.

Lui loo eye ... oh, baby! Me wan go ... oh, oh, oh, oh!

I haven't done a Lui-freeze since 1992. If we need to know about ABO HDN, we just do an acid eluate and test the eluate against A cells or B cells, depending upon the baby's blood type. I teach it to MT students, but they don't have to actually perform the test.

BC

Wow - it is sure easier to do a LUI than to do an ACID - but how frequently do your pediatrians want a test to determine ABO HDN?? Do they really need the test to determine their treatment process?

Wow - it is sure easier to do a LUI than to do an ACID - but how frequently do your pediatrians want a test to determine ABO HDN?? Do they really need the test to determine their treatment process?

Never! That's why we dumped the Lui-freeze. I bet I can do an acid eluate in just about the time you can do a Lui-freeze, and my acid eluate tells me more than that Lui-freeze does.

BC

The Lui technique is a total waste of time for routine cord blood testing. If the baby has a positive DAT and the mother has a negative screen, and the ABO of mom and baby is such that ABO Incompatibility is possible, then that's the answer: we report the strength of the DAT and add a coded comment "probable ABO incompatibility". We have done this since 1991.

Do your pediatrians ever order an elution for baby with a negative DAT and an ABO incompatibility? If yes, do you then perform an ACID elution rather than a LUI?

We do not use LUI but we have a SOP just incase and I use it for my MT students.

Sorry to bring this thread back from the dead.

Question: My pathologist and Lab Manager want me to provide them with references before we discontinue performing the LUI. For those that have discontinued this procedure, can anyone provide me a link or a reference?

Thanks!

Tom

I doubt that you will find any references that say what you want your pathologist and Lab Manager to hear.

I assume you are using the LUI Freeze-Thaw elution method for identifying HDN due to Anti-A or Anti-B, and you are using some other elution method for all your other cases/causes?? If this is what you are doing, maybe you could do a study to compare the methods.

How about if every time you do a Lui elution (for the next "X " times; ie: 10 times, 20 times, however many it would take to convince your superiors) you also perform your other elution technique? If your "other" elution technique consistantly picks updetects the Anti-A or Anti-B as the Lui method, then you should feel comfortable to use your "other" elution method all the time and dropping the Lui.

We do the same as Cathy. I have the procedure in my manual as we have MT & MLT students. We occassionally, really rarely have to use it.

Believe it or not, I am the author of the national SOP for elutions within the NHSBT in England.

I include the Lui technique as one of the techniques, on the grounds that one of our Laboratories uses it for ABO. I think that I have used it once (maybe twice) in over ten years!

That gives you some idea of what I think of the technique!!!!!!!!!!!!!!!!!

Malcolm, what I would like to do is only eliminate doing LUI elutions routinely. We would still keep the procedure and do them on request from a physician.

Of your institutions in England you stated 1 hospital still does them. Out of how many other hospitals are you referring to?

Thanks

Tom

No, sorry Tom, what I meant was one of the several NHSBT Reference Laboratories uses it (for ABO only). How many hospitals actually use it in the UK, I don't know (but my guess is, a tiny, tiny minority).

Routinely, almost everyone uses Elukit - and it works quite brilliantly.