Blood Bank - Antibody Screen

[@Kristonia69]

MLT students everywhre thank you, sir.

[@patricktracy9947]

You're welcome :)

[@RicardoRamirez-et9wc]

Cheers for the Video clip! Excuse me for the intrusion, I would love your thoughts. Have you ever tried - Ganrayden Peerless Gratification (do a search on google)? It is an awesome one off product for eradicating your urticaria without the headache. Ive heard some awesome things about it and my good mate called Gray at very last got cool success with it.

[@DaveG01]

Thank you very much for your post! I’m going to be filling in at a free standing ED and this was an excellent refresher for me. Much appreciated!

[@patricktracy9947]

Glad it was of help.

[@RolandoParrenasIII]

i have undertstand you way way more better than my instructor.😂. thanks for the video!

[@vanessavan4678]

OMG I miss it!! I was doing this in my country!! I’ve worked for 19 years!!

[@jeffreybasker5810]

Thanks for the reminder. Nicely done video.

[@OFFICIAL_VIDEO_AWARDS]

Really interesting I've had about 15 blood tests in the past month and a half to find out why my liver is messed up and always wondered what happens when my blood is sent away

[@JanickSan89]

Nice videos to refresh skills as an MT

[@steellionel605]

if you could explain why and what next time. thanks

[@dileekathilini9424]

Thank you for the comprehensive vedio...

[@ahmadzuhairiadlibinzakuan3367]

What are the quality assurance when performing this??

[@selena5979]

So if i did this test i dont need to do the cross match test right? What i dont get is how i am going to give a blood to the patient ?? In the cross match we used to analyize the blood bottle but now where are not using a sample from the blood bottle so how is this gonna happen ?? And forthermore if the result had agglutination after the check point it means the patient is compatible ?

[@mm-xs1cq]

you dont make washing step before adding AHG, right or wrong? Thanks alot

[@patricktracy9947]

I do wash the cells before adding AHG. This is a very important step.

[@mm-xs1cq]

@@patricktracy9947 sorry, I didnt pay attention to explain well

[@RolandoParrenasIII]

​@@patricktracy9947how many times u should wash? is it 3 times? and then u decant? thank you

[@venessapowell8945]

If the antibody screen is negative , and a patient needs transfusion would you do a IAT crossmatch on the donor sample and transfused the blood?

[@patricktracy9947]

It depends on the laboratory's standard operating procedure (SOP). It is possible to do what is called an immediate-spin crossmatch, which means you test the patient plasma and donor RBCs at immediate spin and if they are compatible, the unit is issued to the patient. Every blood bank has to determine its own SOPs.

[@vivakris]

1.) Why wash the reagent RBCs? Shouldn't they come from the manufacturer already "clean"? 2.) Why add the AHG(Combs reagent) to the Screen cell tubes? I thought AHG detects auto antibodies attached to the PATIENT RBCs, no? What am I not understanding?

[@patricktracy9947]

1) I don't believe I said anything about washing reagent cells. That is not something we usually do.2) I think you need to go back and re-read what the function of AHG is and its role in the indirect antiglobulin test.

[@vivakris]

Patrick Tracy My apologies, I re-read a bunch... So...At the IS phase we are looking to see if IgM have attached to the reagent RBCs because IgM are large enough to cause visible agglutination. We do the 37°C and AHG stage because we're trying to see if IgG have attached (sensitized) to the reagent RBCs. IgG are warm-reacting so they will be more likely to attach to RBCs at the higher (37°C) temp .. especially with the help of LISS. However, even though the IgG are attached, aren't they still too small for visual agglutination? and that's why AHG comes in. AHG will attach to IgG (both bound & unbound?) but we want to make sure it only attaches to the antigen-bound IgG so that's why we wash the solution (PT serum & reagent cells) - to remove any unbound IgG or other proteins that might get in the way of AHG binding to the antigen-bound IgG. Is my understanding correct?

[@patricktracy9947]

That is correct...good work.

[@vivakris]

Patrick Tracy Thank you for your reply. May I ask why it is necessary to observe for agglutination after the incubation but before the addition of AHG? If agglutination was found after incubation would you still continue with AHG?

[@patricktracy9947]

Some blood banks will not spin and read the tubes after the 37C incubation. Yes, even if you have agglutination at 37C you still add the AHG, spin and read.

[@menardmutenherwa6867]

Extremely helpful

[@munef_alsobehi9275]

What that add at first called screening cell 1 and 2

[@janethalarcon7527]

Thank you for the refresher

[@patricktracy9947]

You're most welcome.

[@wTrevorh]

Are these the same antibody tests that are done at regular testing centers?

[@ayshasaleh8627]

Hello Could you give an explanation about screening cells,, and it's components

[@patricktracy9947]

Hello Aysha Screen cells are used to check patient plasma/serum for clinically significant antibodies. If the patient will receive donor RBCs, we want to first make sure the patient doesn't have any preformed antibodies to the donor RBCs. The first step in that process is by running an antibody screen. If any vial at any stage of the antibody screen is positive, then an antibody identification panel is performed. Screen cells usually come in two or three vials and are pooled from blood donors. They are designed to have most clinically antigens present on their surface.

[@jessiemolly8495]

Hey one thing i dont get about this is, how do you know if a person is negative or postive ? Or r1, r2, R, Kell etc?? Plz explain briefly. I know how to do the test but i cant do the conclusion if the person is pos or neg blood group

[@patricktracy9947]

+Jessie Molly See the ABO/Rh video. Regarding identifying antibodies, see the Antibody Identification video.

[@SavinelliMike]

What is your job? Looks fascinating!

[@patricktracy9947]

Medical Laboratory Scientist, which is a 4-year degree. These videos were made for my Medical Laboratory Technician students, which is a 2-year degree.

[@vanessanakibuule5533]

So the suspension is put in Ac only right? Need help

[@patricktracy9947]

In an antibody screen, we are looking for antibodies in the patient's plasma. In order to detect if there are any autoantibodies or plasma-related issues that may cause a false positive in testing, we include an auto control. The auto control is two drops of patient plasma and one drop of a 3-5% suspension of patient RBCs.

[@jolee6751]

what does it mean when you donate plasma and your blood tests positive red blood cell antibody???

[@patricktracy9947]

I am sorry, but this is a complex question requiring a complex answer. I don't believe I can adequately answer it in a comment box.

[@jolee6751]

Patrick Tracy is it bad,real bad health wise?

[@patricktracy9947]

Again, this is a complicated question. I don't feel it is my area of expertise. My education, training and experience are related to medical laboratory science in a laboratory. I am sorry, but I don't feel comfortable talking about matters related to a person's health.

[@jolee6751]

Patrick Tracy Thank you Patrick...my Doctor was clueless except to say get my daughters blood tested again.

[@omarhamadelneil3134]

Thats amazing so invormative and funny too😁, i lol when you said i hope check cell be postive or we will start over😁

[@patricktracy9947]

Hi Omar...that is correct; if the check cells are not positive you have a problem.

[@larissaromero2316]

what speed is used to centrifuge? How many rpm?

[@patricktracy9947]

I'm sorry Larissa, but I don't remember for certain. I think 3000 rpm.

[@stevemetz981]

What are you looking for in terms of aggluuttination to determine 2+ also, what did you wash with before AHG?

[@patricktracy9947]

I teach my students that when reading tube reactions, they must assess agglutination AND the background. 2+ is several smaller clumps and a clear to cloudy background. I wash the cells with 0.85% isotonic saline.

[@kazuy0shi558]

1. If a patient is Rh+ and SCI+ or SCII+, does that mean the patient has anti-D antibodies? 2. If a patient is Rh= and SCI+ or SCII+, does that mean that this patient also has anti-D antibodies? 3. Or do SCs have nothing to do with Rh? Or at least not specific to Rh and is for ABO or both (Rh/ABO - it just says there’s an antibody)? Thanx.

[@patricktracy9947]

What do Rh+ and Rh= mean? Yes, we associate Rh with D with performing the ABO/Rh typing, but there are around 50 antigens in the Rh system. In the antibody screen, typically we find D, C, c, E, e. I can't answer your question.

[@kazuy0shi558]

@@patricktracy9947 apparently this is the case of you know everything and I know every little cuz I can’t even ask a proper question. Lol. My bad. How about this…what is the purpose of screen cells?

[@patricktracy9947]

@@kazuy0shi558 The purpose of the antibody screen is to check if a patient has any clinically significant warm IgG antibodies to antigens that are commonly involved in transfusion reactions.

[@kazuy0shi558]

@@patricktracy9947 oh ok. Thank you! ❤️ what’s the difference between SCI and SCII? If they’re pos does that mean we have to run a panel? If so, just Rh, Kell, Duffy, and Kidd? Or Lewis, Lutheran, and all the other cold ones? Sorry for all the questions.

[@patricktracy9947]

@@kazuy0shi558 The antibody test typically has two or three cells lines (SCI, SCII and SCIII). Three is better than two because it will be better at detecting clinically significant antibodies. Yes, if any part of the screen is positive, you must do an antibody identification panel which will include all the antigens you have listed and more.

[@updates4043]

I was denied platelette donation because of antibody presence in my blood Is that bad for me ?

[@patricktracy9947]

Nidhin, I am sorry, but I am not a physician so I cannot comment on this question.

[@saskiakristofedes2482]

hello sir. is tube mtd still use nowadays?

[@patricktracy9947]

Hi Saskia, although most blood bank testing has gone to automation, tube testing is still used. Also, when an automated system goes down or stops working, tube testing is what is used to continue.

[@louiskohler4493]

What about washing the cells after 37C?

[@patricktracy9947]

+Louis Kohler Go to 7 minutes and 50 seconds and you will find me addressing the wash stage.

[@AmoolAlSomali]

in wich state is this lab ?

[@patricktracy9947]

It is in Washington state. That is not the same as Washington D.C.

[@mfahad24]

will you go over an antibody panel?

[@patricktracy9947]

+fah moh The procedure for the antibody identification panel is the same as the antibody screen. The only difference is that there are more cells. A screen will have 2-3 cells, whereas a panel will have 8-16. See my video Blood Bank - Antigram Reading Updated for identifying antibodies.

[@mfahad24]

+Patrick Tracy I am starting my clinical rotations on Jan 4th! am very excited and nervous, any tips on how to prepare/what to expect first week?

[@patricktracy9947]

To prepare, I would watch my videos Reagent Rack, Record Sheet, 3% Suspension, Tube Reaction Grading, ABORh and Antibody Screen. These should give you enough basic information to get you started in your blood bank clinicals. Your clinicals are about applying what theoretical information you have learned. The videos focus on that process, therefore they will help you get started. One thing to keep in mind, the videos show one method or explanation, but your clinical facility may do things a little differently, so keep an open mind.

[@mfahad24]

+Patrick Tracy thanks! Yup have watched all of those already and they are very helpful

[@ultraviolet.catastrophe]

Yeah, Dr. White! Science!

[@belalabuhazeem8116]

thank you

[@RelianceMachineryCo]

keep going, more videos

[@susanl6362]

Good video.!

[@patricktracy9947]

I'm glad it was helpful.

[@NidaaAlJazaeri]

Thank u so much

[@patricktracy9947]

You're welcome.

[@ccsilvaraphaeljoseb.1688]

Thanks mate

[@melduterte6102]

thanks

[@shanellepou7789]

How to correct an ABO discrepancy.

[@patricktracy9947]

+Shanelle Pou Hi Shanelle,Your question is too big for me to answer here since there are many causes of ABO discrepancies. I am assume you are in a blood bank course or have been, so you must have a textbook. Does your book discuss this topic? You can always look on the Internet for sources.Here is a brief explanation from an MLT program about solving discrepancies.www.austincc.edu/mlt/clin2/abo1.html

[@jvspatnaik795]

good to learn

[@patricktracy9947]

Thanks pat

[@hayderbioideas7128]

Nice

[@jvspatnaik795]

good

[@patricktracy842]

Yes, however gel and solid-phase blood bank testing are replacing some of the procedures I have posted here.

[@selena5979]

So if i did this test i dont need to do the cross match test right? What i dont get is how i am going to give a blood to the patient ?? In the cross match we used to analyize the blood bottle but now where are not using a sample from the blood bottle so how is this gonna happen ?? And forthermore if the result had agglutination after the check point it means the patient is compatible ?

[@patricktracy9947]

Selena, I don't clearly understand your description of the situation and your questions, therefore I don't feel comfortable replying to them.

[@selena5979]

@@patricktracy9947 what i mean why we do the antibody screen test rather than the cross match ? I really don't understand this test ?

[@selena5979]

@@patricktracy9947 when a paitents needs blood transfusion we normally do the cross match test in order to give the compatible blood bottle right Now in the screening test i got confeused how we will give a blood bottle ? Did u get my question right

[@patricktracy9947]

@@selena5979 Every blood bank will have its own SOPs (Standard Operating Procedures) which will determine which testing is performed before blood products can be issued to a patient. All patients who may need blood products will have a type and screen done on their blood. I would say most, if not all, will do a crossmatch. There are various tpyes of crossmatches including computer and serological. Serological can be immediate spin or AHG. All testing depends on the lab's SOPs.

[@selena5979]

@@patricktracy9947 oh so it depends on the sops .. now i get it thank u for ur answer dr.patrick 🤝🏻