Does anyone use cold agglutinin screens for cardiac surgery and does your department even run them?

I used to do them decades ago.  Perfusion had literature about "cold" blood pooling in the heart and causing problems.  My pathologists felt we should accede to their wishes.  We did Immediate spin, 5 minutes at room temp and 5 minutes at 4^oC.  If we had a positive we did an abid at that phase and if specifc, we xm'd ag neg rbcs.  As I said this was decades ago.

Anti-I?  Anti-H?  Anti-HI?.............and you gave antigen negative blood?  Sorry David, but I just can't believe it.

Yeah - come on, the OB guys are always asking for I neg rbcs for their pts (HAHAHAHA!).    -really!

 

No, only if it was an anti-M. 

That is a nice little doable cold screen - it even makes sense.  Our heart surgeons have been worried about cold agglutinins some too as the surgical procedures call for some real cooling of the patients.  I really didn't know what we could do for them that even reflected reality.  We only detect cold "somethings" if they occur in the I.S XM, otherwise we don't even see most colds anymore.  They once wanted us to do incubations at several different temps, gradually lowering them until we reached the standard heart surgery procedure temperature they wanted to use.  They wanted to use the lowest temp that did not show the cold aglutinin. We declined.

Yeah - come on, the OB guys are always asking for I neg rbcs for their pts (HAHAHAHA!).    -really!

 

No, only if it was an anti-M. 

 

David, you would be surprised (or perhaps not, given your experience) just what antigen negative blood I have had requested!!!!!!!!!!!!!!!!!!

Nah.

 

Scott

Come on Malcolm, try and surprise us! 

Well, I remember once being asked for C-, c-, C^w-, D+, E-, e+ blood, on the grounds that the patient had an anti-c and an anti-C^w (at about 02.00 in the morning, needless to say!).

 

Apparently,their Standard Operating Procedure (and it was a very large London Teaching Hospital, mind you) said that, if a patient had anti-C^w, the blood to be transfused should also be C-!  I put them right as politely as I could at that time in the morning!!!!!!!!!!!!!!!!!!!!!!!!

Back in the early '80s when we were washing lots of blood I contacted a Dr to inform them their patient had an antibody (I forget which one) and that it would take a little longer to find compatible blood.  I was informed that since I had a cell washer I should just wash the units and get them to them right away.  Needless to say we had a little discussion. 

^{LOL!  Well, at least they knew that the Lab had a thing called a cell-washer, even if they did not know what it was for!}

^{Like people have related elsewhere here, they could of asked for "universal donor", that's OK for anyone, right?  After all, it Universal!}

 

^Scott