Our LIS Coordinator is getting married this Fall and will be moving to DC, where his fiance has a job she is refusing to give up. This guy is irreplaceable. I'm sooooooooooooo sad !!!

While I continue to extol the virtues of a commuter marriage to him, I have to have a back-up plan. If anyone knows of an LIS-type person experienced in Meditech, please forward my email address. We are about 30 milrs outside Indianapolis, IN.

Thanks.

Larry Smrz, MBA, MT(ASCP)SBB, CQA(ASQ)
lsmrz@mcmh.net

Hi everyone

I'm working in a Blood bank in Middle east (Oman), I have done my degree and Mphil in UK, it's a great oppertunity to learn from this forum, Im really happy to join you :):)

Leema

Is anyone doing this on a routine basis? If so, what criteria are you using for managing any data out of spec?

Most of the pharmceutial industry is now putting data loggers in EACH box and accept/reject shipments in part based on data but they have MKT and allowances for time out of desired shipping temperatures based on stability data and we have preset ranges by the FDA and AABB with no specification for time out of spec. Blood and blood products are much more complex than most drugs and temperature is one of MANY variables that could impact product quality.

This question assumes the box configuration has been properly validated under summer and winter conditions but there are those days that certainly exceed the conditions under which the box was tested and boxes cannot be designed for the absolute worst case imaginable due to cost.

I am 100% certain that temperature of product upon receipt is NOT necessarily an indicator that the product maintained the correct temperature during the shipping process because I have seen it with trial data.

I have also seen data where there is still ice in the box upon receipt [Have heard argument that product did not get too hot if there is still ice in the box] but the product experienced transient increase in temperature out of range [with subsequent recovery]

The last thing anybody wants to do is throw out perfectly good product because of a transient temperature anomaly.

I've a patient 72 years male A ccDEE kk Jk (a-b+) Fy (a+b+) MMss Lu (a-b+) who underwent an urological surgery. His screen was negative in Biovue and we cromatch 3 units of non tiped GRC with a negative results. Another screen 3 cells,ready-id 14 cells extend 1 e 2 in Galileo echo show positive panreagent whith the same strenght Tad is negative.I have made manual tube test Tai 3 cells with autocontrol at 4°,20° 37°without enhancment media, Coombs,enzyme two stage bromelin all the results are negative.
Do you have found antibodies only active in microplate test?
I suspected the presence of anti Ch o Rodg and I made inibition test with A pool plasma Tai in microplate became negative I am on the rigth road or not?
Thanks

I am in the process of revising my SOPs for Daily QC. Historically, Anti-D & Anti-c had been diluted in house to test the screen cells (tube) day of use. For gel, we use dilute Anti-D. I'd like to know what other facilities use to make their dilute antibodies for In house prepared QC.

We are considering switching to the ALBACLONE typing reagents and I was wondering if anyone out there has used them. They are from Quotient Biodiagnostics.

What do you do when you have a very weak Anti-B on the reverse type? We have seen this recently in 2 elderly patients. We are using the gel system now, but still had some cells and were able to do a tube type and get microscopic agglutination. We also had documentation that showed these patients as A in the past. But what do we do in the future when we no longer have cells? I would appreciate any help.

Currently we are using thermal transfer but are considering switching to direct thermal for printing ISBT labels. In addition to RBC's and platelets we make FFP, Cryo, freeze and deglyc. I would appreciate any feedback pro or con for using the direct thermal printing.

Will your laboratory consider performing ABO typing using the slide method, in case of a disaster?
(Scenario: An earthquake happened at night and caused power outage. Your hospital is deluged with
hundreds of trauma victims. The hospital set up treatment area in the parking lot.)

We are currently using Pall's single random donor platelet filter (Purecell PL) to provide leukoreduced platelet product to pediatric patients. We monitor the effecitveness by measuring 4 selected units each month checking for leukoreduction, platelet recovery, and platelet yield. Since December 2009, we started to see some failures with leukoreduction. We have performed a number of studies associated with investigation resulting in approximately 60 units tested within the past month, and are still experiencing about a 7% failure rate (our acceptance criteria is no greater than 5% failure rate). We have also been sending used filters to Pall for investigation (on failures), but their response time is slow (approximately 1 month). There does not appear to be anything lot specific, process specific, or technique dependent. Because we are having difficulty getting our process under control, we are exploring other ways to provide leukoreduced products to pediatric patients. Here is a list of things we are considering:

1) Discontinue the acceptance of leukoreduced single random platelet orders, but allow orders for leukoreduced 2-unit pools (filtering using Pall's Purecell LRF)

Advantages: Leukoreduced pooling process is in control. Therefore product is effectively leukoreduced.

Disadvantage: Increased donor exposure to the patient.

2) Discontinue use of Purecell PL filter and begin using Purecell LRF filter to leukoreduce single RDP's.

Advantages: The product is effectively leukoreduced (according to previous studies)

Disadvantage: The platelet yield and recovery is significantly lower. Additional orders may be necessary to effectively treat the patient.

3) Setup aliquot system for single donor leukoreduced apheresis platelets.

Advantages: The product is effectively leukoreduced (according to previous studies)

Disadvantage: Apheresis platelet inventory is highly variable. No validated system to provide this product. Apheresis storage bags have storage specifications that when a certain amount has been removed, the remaining product can no longer be stored (according to manufacturer specificaitons) resulting in increased wasted product. Developing, validating and implementation of a process is a long-term project.

We are considering (in the short-term) going with either option 1 or option 2. Ultimately, we are moving toward option 3, but this will be long-term.

The reason for my post is that I am interested in what other facilties do to provide leukoreduced platelets to pediatric patients. Any other comments regarding our situation is also welcome.

Thanks much!
Mike

We have been recently having discrepant Rh typing results, especially from Moms whose pre-natal testing was performed in another Lab. I have been asked to send a memo to the Medical Staff explaining how this could happen. I was wondering if anyone has already had to deal with this issue. I began to quote Chapt 13 of the Technical Manual, but I realized that the physicians probably would not want to read anything in this detail. Any physician memos circulating out there regarding D antigen typing & clones from various vendors???:cries: