NHBST RCI crossmatching terminology

[Donna]

Hi,

I have a question, I am wondering if everyone is happy with the terminology that NHSBT RCI labs use for crossmatched red cells?

We recently had a case which could of led to a potentially serious transfusion reaction twice in a week as blood was sent to us as ‘suitable’ but not all the work had been completed and on both occasions the blood was very unsuitable. Luckily our BMSs held their ground at detecting and escalating serious incompatibilities, anti-Jsb, anti-S, anti-D and possible anti-Fya were detected by IBGRL over the following week. Then a serologically compatible unit was sent but still labelled ‘suitable’. It was a difficult case with limited information available as the patient was from overseas and the NHSBT were incredibly helpful, however I feel that the terminology used by NHSBT is very vague and uninformative to our BMS staff actually issuing the units.

What does everyone think and could there be a better way?

Donna

[Chris Robbie]

Hi Donna

I can't comment on NHSBT terminology, but from your description, this case "could" be reportable to MHRA on SABRE. Have you reported it? If not, please do and I can assess the detail more closely. Or, call me should you wish to discuss first.

Thanks

Chris

[Donna]

Thanks Chris

I just had a chat with Mike about it.

Donna

[Chris Robbie]

No problem - I was on another call when you called.



As a general point, if a reporter is unsure whether to report a problem or not, it's always good to report with all the detail so we can assess and follow up with third parties. Then I can make decisions about whether the third party should report or not and whether to exclude the original reporter's report based on the info provided.

Also, always happy to take calls to discuss and emails.

[Rashmi]

Hi Donna,
Would also be useful to contact your local RCi about their terminology.

The blood you describe is probably from frozen rare stocks and may have been sent to you as antigen negative to the known antibodies, though not necessarily serologically compatible, hence sent as suitable.


As always it is a clinical decision based on patient condition to transfuse blood, regardless of antibodies being present. I remember a case from long ago when there was a delay transfusing a severely anaemic post-partum patient with emergency blood, due to presence of enzyme-only reacting Anti-E, and a decision made that more suitable R1R1 units should be used. Prior to the blood being received the patient arrested and died.

bw

[Lumuss]

Hello Donna,


I'm studying Red Cell Immunohaematology this year and we had a chat with Helen Owens, Specialist Biomedical Scientist from NHS Blood and Transplant in Newcastle. So after tbat, I contacted my local RCI about the terminology.