How do we operate a large monthly red blood cell exchange program.

Background: Red blood cell (RBC) exchange for sickle cell disease presents unique difficulties due to RBC phenotyping, complex antibody work-ups, large number of RBC units required, and vascular access considerations, any of which can delay the procedure. Multidisciplinary coordination and systemic processes ensure that monthly appointments remain on schedule.

Study Design And Methods: A high-volume chronic RBC exchange program is described, highlighting the importance of multidisciplinary coordination and process improvement strategies involving initial referral, vascular access, order sets, and allocation of antigen-negative or phenotypically matched RBCs.

An unusual case of anti-D detection in two consecutive D+ patient samples: Antibody carryover on an automated gel platform.

Background: Laboratory results can be affected by sample to sample carryover. Carryover of different analytes occurring in automated clinical chemistry, immunology, hematology, and molecular laboratories is well described. However, carryover in a transfusion service laboratory is not reported in medical literature.

Unexpectedly Weak Anti-B in 2 Group O Pediatric Patients on Parenteral Nutrition and Disease Specific Supplemental Enteral Feeds.

Anti-A and anti-B antibodies are naturally occurring and develop from exposure to intestinal bacteria after age 4 to 6 months. In the laboratory, strong agglutination with A1 and B cells, or B cells only and A1 cells only, on reverse typing in a healthy person with immunocompetence is expected for patients with ABO types O, A, and B, respectively. However, absent or weak anti-A and anti-B antibodies can be observed in some clinical scenarios, such as patients with immunodeficiencies, newborns, elderly patients, and patients who have recently received bone marrow transplants.

Electronic patient identification for sample labeling reduces wrong blood in tube errors.

Background: Wrong blood in tube (WBIT) errors are a preventable cause of ABO-mismatched RBC transfusions. Electronic patient identification systems (e.g.