31 July 2019 (Wednesday) - BTLP - TACT excercise

I had an email from the BTLP-TACT people today. I was a tad miffed to read “… you may need to complete further TACT participations to improve your engagement target with the system” when I’m told by all of my colleagues that I do far more exercises than they do, and that they don’t get these reminders.
The last time I did one was two weeks and one day ago. How often am I supposed to do these? But it is good CPD, and it is free…
I was presented with one case; a twenty-two year-old woman needing two units of irradiated blood within the next two hours. She typed as O Pos with a negative antibody screen. I selected two units of O Pos irradiated blood (both of which were K-negative)… and got the green light.

31 July 2019 (Wednesday) - Sample Quality

Here’s something I read in one of the work-related Facebook groups I follow:

 (This is from the USA - *not* anything to do directly with me!!!)

But this made me reflect - What we do is only ever as good as the samples with which we are presented…

31 July 2019 (Wednesday) - Transfusion Evidence Alert Update

The nice people at the Transfusion Evidence Alert sent their update today. One or two useful snippets:


Myocardial Iron Overload in Sickle Cell Disease: A Rare But Potentially Fatal Complication of Transfusion
Tavares AHJ, Benites BD, et al, Transfusion medicine reviews 2019
A Phase 3 Randomized Trial of Voxelotor in Sickle Cell Disease
E, Vichinsky, CC, Hoppe, et al. The New England journal of medicine 2019
Efficacy of fibrin sealant in thyroid surgery. Is drainage still necessary?
G Geraci, B D'Orazio., et al. Annali italiani di chirurgia 2019.
Preoperative anemia and outcomes in cardiovascular surgery: systematic review and meta-analysis
H Padmanabhan, K Siau., et al. The Annals of thoracic surgery 2019
Effective ways to retain first-time blood donors: a field-trial study
S Hashemi, M Maghsudlu, et al. Transfusion 2019.

29 July 2019 (Monday) - Pos or Neg?

At the weekend I had an interesting case. Two samples from the same patient which the analyser grouped both as “A”, but with an indeterminate Rh group. I performed the groups (both long groups and check groups) and made both A Rh(D) Negative. But I looked closely at the analyser plots. Was there something in there?
The standard operating procedure says that the anti-D reagent should be used macroscopically, but under the microscope was some very small agglutinates.

Reference to SPI-CE came up with the patient who had been tested from another hospital. They were known to have a weak Rh(D). A *very* weak Rh(D).

Now… had there been analyser failure and had I been working using manual techniques I would have called this patient Rh(D) negative. For a transfusion point of view this would have been fail-safe as I would have transfused Rh(D) negative blood. However if this had been an ante-natal patient I might have issued anti-D.
I’ve been fretting about this…

There’s more on weak D and D variants that you can read by clicking here