12 January 2020 (Sunday) - BTLP-TACT Excercise



I did another BTLP-TACT exercise today. I was presented with one case – a sixteen year old lad with haemophilia requiring a group and save.
He grouped as A Rh(D) Negative with a positive antibody screen. The antibody appeared to be anti-D, but anti-Cw could not be excluded.
I got the green light…

9 January 2020 (Thursday) - Antigen Incidence


Here’s something to make you think. This appeared on the Blood Bank Interest Group on Facebook posted by someone with whom I went to college (nearly forty years ago).
It is a scan of a blood group antibody panel that was being used in China in June 2005. Note also the need for Di(a) on the panel, that only three of the cells were D Negative, and that NONE of the cells were either K Positive or Fy(b+).
It is easy to overlook the racial variations of blood group incidences.


9 January 2020 (Thursday) - Transfusion News update



The nice people at “Transfusion News” sent their update today. I would have liked to have seen more about the American platelet transfusions. I suspect that money plays a large part in those as opposed to here in the UK…


Gene Therapy for Hemophilia A Decreases Bleeding
January 8, 2020
Adeno-associated virus (AAV)-mediated gene therapy is a promising new treatment for hemophilia A which decreases bleeding and thus risk of transfusions for these patients, but little is known about the long-term efficacy of this treatment. As reported in The New England Journal of Medicine, a single dose of [Read More]
Platelet Transfusion Use in the United States
December 30, 2019
Although RBC transfusions have decreased over the past decade, the demand for platelet transfusions has increased. In order to better understand platelet transfusions, researchers retrospectively analyzed electronic data from 2013 to 2016 from 12 US hospitals participating in [Read More]

8 January 2020 (Wednesday) - Fritsma Factor Newsletter



The “”Fritsma Factor” newsletter appeared in my in-box this morning. Discard tubes, case studies… this is becoming one of my better sources of CPD – and effectively my only consistent source of CPD relating to haemostasis.

3 January 2020 (Friday) - Myeloma Update



The nice people at the American Society of Hematology sent an update on myeloma today. You can see it by clicking here.
Free CPD is always good… and from a reliable source too. The internet is awash with crackpot pseudo-science. Finding something worth having is something of a result.

31 December 2019 (Tuesday) - Acquired HbH Disease



In conversation today we heard about acquired Hb H disease. “Acquired”? – you don’t acquire that, do you?
Apparently you can do. It’s rare, but it happens in some cases of myelodysplasia.
One lives and learns…


Z1234567            DUCK LEWIS T           01.02.79  M  T
Specimen 1234      Clin dets MDS with acquired HbH
Collected 31.12.19 10:20     A.Diag 
----------------------------------------------------------------------------
Hb         - 65           |Eosin      - 0.00
WBC        - 2.35         |Baso         0.03
Plts         246          |MPV          0.0
Hct        - 0.230        |PCT          0.00
RBC        - 3.68         |NRBC         0.95
MCV        - 62.5         |RETP         1.5
MCH        - 17.7         |RETA         56.70
MCHC       - 283          |IRF          27.0
Neuts      - 0.56         |
Lymphs       1.40         |
Monos        0.36         |
DIFF       Blood film shows anisopoikilocytosis with target cells,tear drop cells and red cell fragments seen



28 December 2019 (Saturday) - BTLP-TACT Exercise


With a couple of minutes spare I thought I might do a BTLP-TACT exercise.

I had two cases:

81327 – a ninety year old male in the out-patients department requiring two units of blood within two hours

The ABO group was A; the Rh group indeterminate. The antibody screen was negative
I selected two units of A Neg

56046 – a thirty year old female in the theatre requiring four units of blood tomorrow

This patient was A Pos with no antibodies detected.
I selected four units of K-Neg A Pos blood

I got the red light… 
In the first instance the entire group was supposedly uninterpretable.
In the second instance “The issued component does not meet specific requirements for this patient.” – I wonder why not…

I tried again.

One patient – a fifty year old male requiring two units within two hours. The labelling of sample did not match that of the form. I rejected it. Green light !!