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Research ArticleFocus: Immunohematology

Organizing the Antibody Identification Process

Michelle R Brown and Peggy Crim
American Society for Clinical Laboratory Science April 2007, 20 (2) 122-126; DOI: https://doi.org/10.29074/ascls.20.2.122
Michelle R Brown
are clinical laboratory scientists in the transfusion service at the University of Alabama at Birmingham, Birmingham AL
MS MT(ASCP)
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  • For correspondence: mrbrown@uabmc.edu pcrim@bellsouth.net
Peggy Crim
are clinical laboratory scientists in the transfusion service at the University of Alabama at Birmingham, Birmingham AL
CLS(NCA)
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  • For correspondence: mrbrown@uabmc.edu pcrim@bellsouth.net
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  1. Michelle R Brown, MS MT(ASCP)⇑
  2. Peggy Crim, CLS(NCA)⇑
  1. are clinical laboratory scientists in the transfusion service at the University of Alabama at Birmingham, Birmingham AL
  1. Address for correspondence: Michelle R Brown and Peggy Crim, clinical laboratory scientists, Transfusion Service, University of Alabama at Birmingham, 619 19th Street South, Spain Wallace W293, Birmingham AL 35233. (205) 934-6390, (205) 975-9260 (fax). mrbrown{at}uabmc.edu, pcrim{at}bellsouth.net.
  1. Identify two areas in which safety of the blood supply has been addressed by the blood bank community.

  2. Identify two possible consequences of an unexpected, complicated antibody problem in a pre-surgical patient.

  3. Explain why an antibody identification summary form is useful in communicating with the clinical staff and other members of the laboratory staff.

  4. List three items that should be included in the history and serology sections of an antibody identification summary form.

Extract

The focus on patient safety issues in recent years has led to implementation of hospital-wide processes meant to decrease risk of errors that lead to adverse events. The consequences of patient identification errors or testing errors even in as straightforward a procedure as ABO typing have been recognized for years.1-5 Ongoing concerns about transfusion-transmitted disease have resulted in enhanced testing for viral diseases such as hepatitis C, human immunodeficiency virus, and West Nile virus. Changes in blood donation criteria have been made in response to the emergence of Chagas disease, Lyme disease, and babesiosis. Electronic procedures such as bar-coding for patient identification are additional methods that increase transfusion safety.6,7 There is a concurrent push for physicians to decrease allogeneic transfusion volume. Some methods for this include re-evaluation of traditional transfusion triggers, review of surgical blood order schedules, and promotion of autologous products and intra-operative blood conservation.8-11

Despite the alternatives to allogeneic transfusion, there are occasions when a patient must receive a transfusion during surgery or perhaps a series of transfusions due to chronic disease or treatment for malignancy. Despite the relative safety of the blood supply, there is no way to prevent transfusion-triggered alloimmunization. Patients undergoing chemotherapy may require extensive component support. One study of a group of cancer patients showed that approximately 9% formed alloantibodies and that risk of developing alloantibody was 0.5% per unit transfused.12 Other studies have shown that once patients had developed a single specificity, they had increased probability of developing additional specificities.13 Some patients initially…

ABBREVIATIONS: UAB = Universtity of Alabama at Birmingham Hospital; DAT = direct antiglobulin test.

    INDEX TERMS
  • antibody identification summary
  • delayed surgery
  • transfusion errors
  1. Identify two areas in which safety of the blood supply has been addressed by the blood bank community.

  2. Identify two possible consequences of an unexpected, complicated antibody problem in a pre-surgical patient.

  3. Explain why an antibody identification summary form is useful in communicating with the clinical staff and other members of the laboratory staff.

  4. List three items that should be included in the history and serology sections of an antibody identification summary form.

  • © Copyright 2007 American Society for Clinical Laboratory Science Inc. All rights reserved.
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American Society for Clinical Laboratory Science: 20 (2)
American Society for Clinical Laboratory Science
Vol. 20, Issue 2
Spring 2007
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Organizing the Antibody Identification Process
Michelle R Brown, Peggy Crim
American Society for Clinical Laboratory Science Apr 2007, 20 (2) 122-126; DOI: 10.29074/ascls.20.2.122

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Organizing the Antibody Identification Process
Michelle R Brown, Peggy Crim
American Society for Clinical Laboratory Science Apr 2007, 20 (2) 122-126; DOI: 10.29074/ascls.20.2.122
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Keywords

  • antibody identification summary
  • delayed surgery
  • transfusion errors

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