A question for our hospital friends>

When you receive an antigen negative unit, what do you get to verify that the unit is negative for the antigens you need? Paperwork? What kind? A tag? sticker? One of our hospitals is being inspected today and the inspector thinks there should be paperwork from our computer system linking the donor to the unit and the Ags that are negative to the donor/unit. Do any of you get this kind of info with each unit? I think at most, people usually get a "tagged" unit listing the antigens tested and MAYBE a piece of paper listing the exact same information. Thanks ahead of time for your input. Havent worked in the hosp. enviroment in quite a long time and maybe I'm out of the times more than I think.

Edited June 12, 200916 yr by OPUS104
cant spell to save my life

From the point of view of the NHSBT, it depends upon the antigen.

Often, the negative antigens are actually printed on the bag label, but the positives are not. However, both the positive and negative antigens are printed on a luggage label attached to the units. There is no accompanying paperwork per se.

If we cross-match the units, then we will send out a cross-match form that will say on the bottom the antigens for which the bags are negative.

If the unit is very rare (i.e. it comes from the National Frozen Blood Bank), there is paperwork stating that the unit is negative for whatever (e.g. it is a Vel-), but it will not say so on the unit label itself.

Do you know what agency the inspector is representing and what reference or standard they're interpreting? Since the inpsector is assessing against the regulations or standards, what the inspector "thinks" is not really pertinent if the regs do not specify or require. Does the inpsector also expect to have the associated ABO/Rh testing paperwork and the individual infectious disease testing results with S/CO provided for each unit as well??

As you stated, I've seen it done numerous ways but generally there is either a tie-tag attached or label present on the unit indicating what antigens are negative, and/or there is some kind of accompanying report with the unit number(s) and the interpretation of the final test result(s).

Usually we get units with tag attached to it has antigen neg status listed plus we get paperwork from donor center with same information. We receive unit in our LIS and enter antigen status in our computer. At the time same information gets printed on tie tag for the unit, if the antigen is rare and not defined in our LIS, we hand write teh information.

WHat SMW wrote is correct, ask for reference standard or regulation. As long as you are meeting the standard requirement you should be OK>

Our units have a tag on then denoting which ags are negative. Our blood center reference lab is CLIA and CAP accredited. In the process of becoming AABB accredited

If there was a question about the unit it could be traced back to the blood center records via our BB computer system and theirs.

When we enter ag neg units in our system we add the ag neg comment, i.e. K-, Fya- etc and append the message "performed at XXXXX reference lab".

We have a "luggage label" tag with historical typings on the donor the unit came from, but if we actually need to care about the phenotype, we repeat it on a segment from that unit - just in case there's been a transcription error somewhere. It doesn't happen often, but more often than anyone likes.

If our blood supplier is just giving us the information as simply that it is hand written on the unit and is only historical info-we don't do anything with the information. If the units were requested by us as Ag negative - the units will come to us with a tag stating Ag status. We re-type all of our units for Ag status and enter our own results in the computer - so it would probably not be an issue with this inspector. I agree that they need to show the standard not cite on opinions.

Jamie and Karen,

I can understand how you can type the units for the "normal" antigens (say Rh through to Kidd) as the grouping antibodies are pretty cheap and easy to get hold of, but how would you check that a unit is, say, a Vel or Lan Negative? Surely, you would have to rely on your supplier on these occasions?

The inspector raised a good question; once the unit is transfused and the blood bag destroyed--the hospital has no documentation from the supplier stating that the unit is negative for a particular antigen. The packing slip from the supplier states Gr & Rh only. If a legal question arises, the hospital has no documentation to protect itself.

Surely, in the event of legal action, the hospital could get documentation from its supplier. I'm sure the lawyers would make sure of that.

I would think so, too.