Hi, is there anyone knows what AABB standards that specify how many hours the blood should be hanged , while waiting for allergic reaction to subside ?Because there was a discussion why for returned units of unused blood to blood bank must be < 30 minutes if kept outside the fridge,while pricked units wherein IV set is still attached to patient can still continue even more than 30 minutes?

I've just returned from a 2 month period serving with Mercy Ships (www.mercyships.org) on board the hospital ship Africa Mercy in Lome, Togo (W. Africa) and will be returning to the Africa Mercy in January 2011. We have a unique way of dealing with the the transfusion needs of our surgical patients -- our crew members serve as a "walking blood bank" and we do not store any processes units. Donors are drawn and the still warm whole blood unit taken to the OR suite or patient ward for transfusion!

Many things are done differently there than here! But, one thing perhaps some of you might be able to help with is a need for a better means of sealing off the units of blood we collect for transfusion. Currently we are tying a couple of knots in the tubing before beginning the collection, then tightening those knots once the collection is completed to seal off the unit. I've asked my supervisor to see about obtaining a portable tube sealer, or at least the metal crimps, crimping tool, and tube stripper, as well as a collection scale. She will be persuing this, but in the meantime, if anyone out there has some of those metal crimps, crimping tools, or tube strippers sitting around that you no longer use, perhaps you might be able to donate them. Feel free to contact me about that, or if you might be interested in serving for a few months or a few years with Mercy Ships!

How do you handle QNS specimens for Blood Bank? Do you begin testing on the sample or do you immediately request a recollect? And if you begin testing on the short draw sample, how do you handle a new specimen if it is drawn for additional crossmatches? Do you do a complete type and screen on the new specimen or just an ABOrh?

Our Blood Bank just entered the wondeful world of computerization last December. Nursing would like the blood tags to stand out in the charts by making them a color other than white. My question is does anyone know if regulations still require that colored tags conform to the old standard of blue for type O, yellow for A, pink for B, white for AB? I'm thinking since nearly everyone is probably printing tags from an LIS now, most of the tags are black ink on white paper so maybe no one cares if colored paper is used, as long as all the tags are the same color. The CFR does mention the colors, but in reference to labels for blood bags. If someone does know where a reg or standard is, please point me to it as our nurses always want to see the reference. Thanks.

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On a related note, does anyone have experience using Medion cells? I am looking for alternatives to the greedy big guys??

We've had our Echo for coming up on two years. In March of this year, we started seeing a new phenomenon. When we get Rh negative OB patients, very frequently they come up with an Anti-D pattern of at least 2 to 4+. The problem is when we do these manually (tube), they come up negative. If we send them to our reference lab, ALMOST always they come up negative for Anti-D. In ALL cases, these patients have gotten Rhogam.
I've tried to find a good way to handle this; we used to do the screen manually and report as negative, but because of those few Antibody ID's that were coming back positive, I felt we were not giving the docs the entire picture. So what we do now is to run the screen on the Echo, if it is positive, we run it manually. If it's negative, we report both workups WITH a comment saying when the patient got Rhogam and that manual testing methods showed no reactivity. It also asks the doctors to notify the lab if they want an ID done. Sometimes they do and sometimes they don't order one; I felt addressing it this way gives the docs all the information they need to make an informed decision about ordering an antibody ID, putting the ball in their court. Since we send these out, it's a significant extra cost for the patient.
I have some techs who hate doing it this way (they liked the other way that didn't involve as much work and thought), and some who think it's great; oy vey! But I should mention I'm the only "official" blood banker in my lab as well as being the supervisor; everyone else rotates in and out. Any thoughts, suggestions, anyone else having this problem??:cries:

We have a 15 yo male patient who is 9 years post renal transplant. Last known transfusion was in 1996. This patient has been identified with anti-JkB in solid phase with 2 and 3+ reactions. Patient presents with slightly decreased urine output but clinically is otherwise asymptomatic. He been noncompliant with medication.
The technical manual gives a brief mention of Kidd antibodies acting as histocompatiblity antigens in renal transplant. I have not found any other illuminating information on this relationship. I found it curious that the reactions were so strong (and neatly fitting) in a patient so far removed from transfusion. I know that Kidds famously do not always follow the rules but...
I was hoping someone might have further information or insight.
Thanks in advance!
Mary

I'm working in one private laboratory in Hong Kong, one of our client is a stem cell bank company. The company have cord blood samples sent to us for ABO&Rh typing.
I do not have any working experience in hospital or stem cell laboratory, so I have some questions about the cord blood samples for ABO testings:

1. Why the stem cell companies need to do the ABO&Rh typing on cord blood samples? Theoretically, the cord blood sample is not a baby's blood or mother's blood. If the companies need to know the baby's grouping, the better way is they can test on the baby's directly. Agree?

2. Most of the cord blood samples can give very clear-cut ABO results, however there is a few samples will give very questionable results, like mixed field (a small solid clump with cloudy background in tube method and displayed double cell populations in gel column). How can we report these samples and what further actions can be taken to protect ourself? We suggested the company repeat the test on baby's blood, but they refused. The reason is: it will border the client and will make the client query the cord blood sample is correct or not.

3. If the cord blood sample is Anti-D negative, it need to do weak D test or not?

Thanks for your help.

I vaguely remember a post from months ago, regarding a need to perform IS phase along with an AHG crossmatch.

The posting had to do with some newsletter stating that CLIA demands a test for ABO incompatibility, to which an AHG crossmatch is particularly insensitive. If I remember correctly -- always suspect in my old age -- the discussion scientifically understood the rationale, but disagreed with the requirement. A subsequent article (somewhere) studied the ability of an AHG crossmatch to detect ABO incompatibility, and the numbers showed that (surprise!) it does a very poor job.


Does anyone remember the AABB or CLIA commenting on this?

We just purchased a tube sealer from Baxter. Will appreciate if anyone can share the validation protocol and form for validation. Thanks.

Hi all,

I know the place for this is in the "Job" tab, but I tried to post it there and it wanted a PayPal account for the posting fee for listing a job, which I don't have, so I'm spreading the word, here!

Anyway, we are in dire need of a blood bank supervisor at out campus in North Central Massachusetts, so if anyone out there is looking, looking to relocate, knows someone who might be interested, here's the link to the position:


https://jobs-healthalliance.icims.com/jobs/2980/job


You can also PM me and I can give you the contact info for our Lab Manager if you want to speak to someone regarding this position.

Thanks and hope to get this position filled soon!!

I am trying to refine my blood type calculation for cords and infants. This is the only time that we routinely perform weak D testing. I don't want to confuse the doctors by reporting out a weak D patient. If I could have one calculation where the Anti-D could be positive (Rh pos) or the Weak D posiitive (Rh pos) it would be wonderful. Sadly, I have been working on this long enough that I've suffered almost complete brain drain! Thanks for your help!!!!!!

:confused::confused::confused::cries::cries::cries :

What type of Automation is used in Europe?

Ortho sends Autovue out and keeps Provue in the US.

Anyone have experience with DIAMED automation? I use the manual Diamed so it would be practical to just move to automated in the same direction, but I would like to know how users feel about it...

Thanks :)
Liz :work:

I work at a small hospital that performs limited testing. We use the gel card and that is about it. We do not keep any antibody tube testing reagents in house. We recently had a patient that had 3 non-specific reactions on a 11-cell panel. All clinically significant antibodies are ruled out but the antibody was reported as a Non-specific Cold. My problem now is, the pathologist was informed that the patient had a cold auto and he requested that a blood warmer be used(which we rarely use). Would you have reported this as a cold? How can you tell it is a cold just using the gel card? Wouldn't Antibody with no Apparent Specificity be a better ID? My suggestion would be to just give crossmatch compatible red cells and not use a warmer, what am I missing? Thanks!

We have just resolved a problem with carry over on the ProVue and I'd like to know if anyone else has experienced the same thing. The carry over was only seen on the antibody screen and with strongly positive specimens. We were fortunate in that 2 of the specimens involved were prenatal specimens. So titers were done on them. One specimen had anti-c (128), anti-E (128) and anti-K (8). Carry over was seen with the anti-c and anti-E but not with anti-K. The other specimen had anti-D (128) and anti-C (2). Carry over was seen with anti-D on both Rh positive cells. The last specimen contained anti-D, titer unknown and carry over was seen on both Rh positive cells.

The problem turned out to be caused by a reversal of the tubing of the wash solutions. At some point in the system, the tubing for solution A was connected to the hook up for solution B and vise versa. This was not the connection at the wash bottle but further back in the system and was done by the Ortho repair tech. While it seems likely that the problem occurred because of an error on the part of the repair tech, I'd like to know if anyone else ever encountered carry over on the ProVue.

Just got a report back from the reference lab warning that a patient has a "high titer" anti Chido. We were warned that the patient may not fare well if given plasma containing products, with the possibility of an anaphylactic reaction.

Any words of wisdom on this topic would be greatly appreciated.:)

How do diseases correlate with the abilityof the patient to mobilize his/her stem cells? Does anyone have a reference to this please?

Thank you

Liz :)

What is the CD34 count in the total aulogous PBSC collects that is sufficient for an adult? For a Pediatric patient?

Thanks
Liz :)

How often is it recommended to flush the Hep-lock of a central line to keep it patent in between stem cell harvests?

Thanks

Liz

What is the minimum peripheral blood CD34 count at which you would perform an autologous PBSC harvest, for adults and for pediatrics?

Thank you
Liz