Thank you so much for the video, some videos for this are like an hour long, and you are summing it up so nicely. It is a nice review because I basically know what I am doing, but need to make it all crystal clear for a practical coming up.
I've read from a textbook that K antigen is also a low prevalence antigen which may be excluded if not homozygous (an exception). I'm wondering if this exception should be followed.
Hello zucccccc, every lab will write its own standard operation procedure (SOP) for testing which should address such matters. I cannot say whether K should or should not be excluded if not homozygous; it's really up to the SOP. If you are in an MLT or MLS program, ask your instructor about ways to handle ruling out low-incidence antigens.
@@zucccccc7467 One thing to note, even though the K antigen doesn't appear often in a typical antibody identification antigram, I wouldn't really consider it as low-incidence. It is usually present in at least two cells, whereas Lutheran-a usually doesn't appear at all.
I gave Jsa an X and completely ruled it out because it is a low-incidence antigen. There are different ways to approach ruling out antibodies with some being more conservative than others. If I were to be very conservative, I would not have completely ruled out Jsa, but would have done further testing to completely rule it out. If this patient were to receive a crossmatch which turned out to be incompatible, then I would return to the antibody identification panel to see if a low-incidence antigen like Jsa were the issue.
mind asking, at panel 11, the JSa was (+ve) and JSb (+ve) so both was heterozygous isnt it? but why does the JSa were not single cross (/) at panel TC?
Hi opiumden, the most common pairs that are used for determining dosage are Ee, Cc, Kk, JkaJkab, FyaFyb, MN and Ss although these are not the only pairs you need to pay attention to. As you can see, there is no m. M is paired with N. That is why M is heterozygous.
thanks for this video highly appreciated, by the way, im a volunteer trainee at a component processing unit, I wonder if panocell is used for tube method, because I saw my staff also doing an antigram of Panel C, using gel card method, p.s. they're using OrthoInnova/ OrthoMax Vision machine, if ever in the future also make a video in terms of gel card and automation. thanks again! looking forward for more educational and informative tutorials, you inspire us a lot. God Bless.😇
i dont understand, why does Big M was heterozygous and it should be given single cross at first? more confusing, it gets homozygous and double cross then. do you mind explaining it?
Hi, M is heterozygous because MN is a pair not Mm. This is a unique group of antibodies-MN Ss. You can also read the previous comments for reference where the lecturer points that out.
Thank you so much for this video. I know how to cross out but after finding the antibody I don't know what to do. I don't know if I was doing the rule of 3 right.
Hi Fritz, applying the rule of three can be a bit tricky, especially for confirming the three positives. I could Zoom with you and explain it if that would be helpful.
Hello! I have a question. During the antibody screening, will you consider significant antibodies that showed little dosage? Loved your video btw, I always use it as reference
Hi Meriam,You are right; I should have put a single slash through Js^a. This will not affect the outcome of the panel. This also illustrates how easy it is to make an oversight on all these little boxes.
Patrick Tracy even though you didnt put one slash on that antibody, it was quite understandable that it was not ruled out. Thanks by the way! Great lecture 😃
Do you need to use donor cells to do Ab identification for patient? Or just the company reagents (11panel)!? Because on the left i see (Donor) written over there
The antibody screen and panel reagent cells are labeled as "donor" because the RBCs in the reagent come from human donors. Do not confuse them with a donor of a unit of RBCs.
Is alloantibody screening must or optional before transfusing PRBCs? And after TYPING what's the rationale behind doing antibody screening with blood type O first rather than directly going for cross matching between patient serum and sample from actual PRBC unit we're gonna use?
Theoretically, the antibody screen is not needed, but I don't know of any blood banks that would not do it. The screen may detect antibodies that may not be detected in the crossmatch.
I think C.M is the final check for ABO compatibility. Now if the patient is having weakly reactive alloantibody( Let say it anti-jka) and donor is heterozygous for that antigen[ jk(a+b+)] then in cross match the alloantibody may not be detected( because few antigens are available for weakly reactive Ab) but on screen it should react because screen cells are homozygous[ jk(a+b-) ]for the antigen( all the antigens are jka on screen cells) We use 'O' cells in Ab screen because they don't have A or B antigens and don't react with anti-A or anti-B antibodies of patient and only detects non ABO antibodies. Sorry for the bad English 😂
First of all, in order for a person to produce an antibody targeted at RBCs, they MUST lack the corresponding antigen. Second, the antibody identification method used in this video is routine and would be reliable in most situations. There was nothing out of the ordinary with this patient, so yes I am confident that there is sufficient evidence.
With this patient, we did not use antigen typing to confirm the antibody. Under normal conditions, we wouldn't do that. We mainly do antibody screening and identification to support crossmatches. If for some reason an antibody went undetected in the screen or was misidentified, it should be detected in the crossmatch if the facility has a crossmatch procedure which uses the indirect antibody test with anti-human globulin.
Sorry, I am not sure what you mean by scribble. When writing antibodies big C and little c, we put a line over the top of little c to make sure it is not confused with big C. For big K and little k, there is a slight difference in how they are written to indicate which one is big and which one is small. I cannot show you here, because I can only type.
@@annaly6612 Again I have incomplete information. You refer to Js. Is that Jsa or Jsb? The reason I am being particular about this is because it seems like you are not closely paying attention, and that is what causes mistakes.
Kelly doesn't show dosage, neither does Lutheran.......or lewis........yet u cross out in a way tht suggests tht they do.....eg: u could have fully crossed out the Lutherans at cell 8 yet I'm seeing a single cross through Lutheran a
I am just being conservative. Some blood bankers believe all antigen pairs should be treated as if they exhibit dosage. It's better for students to learn a cautious approach. When they are certified techs working in the field, they can expand their approach to blood banking while in the confines of the standard operating procedures of the lab they work in.
This clears up so much, I was so confused trying to learn this on my own
Thank you so much for the video, some videos for this are like an hour long, and you are summing it up so nicely. It is a nice review because I basically know what I am doing, but need to make it all crystal clear for a practical coming up.
Hi James, yes I paid attention to the length of the videos while making them. Keep is concise. I am glad the video was helpful.
This is one of my core competency requirements of my program, this helps so much!
I am glad it was helpful.
As an MLT student, thanks for the explanation!
I didn't know this could be this easy! Thank you very much!
You're welcome.
Absolutely amazing and easy to understand!! Thank you for this video
This helped a ton. I understood the steps prior to watching this but I understand the logic now. Thanks!
Thanks Eric...I am glad it was helpful.
Super thank you somewhat it gives me an idea i been trying to understand this one for quite a long time now..
You are welcome.
Thanks for this video...im preparing for licensing exams in clin lab scientist and this video is a big help😉
I'm glad it was helpful.
This has been confusing for me but I understand now. Thank you!
Well that's good!
I won't be scratching my head anymore. Thank you!!!
You're welcome.
Great video, very informative
Thank you
Thank you. Easy to understand
So clear explanation and easy to follow.Thank you
I am glad it was helpful Zohreh.
I've read from a textbook that K antigen is also a low prevalence antigen which may be excluded if not homozygous (an exception). I'm wondering if this exception should be followed.
Hello zucccccc, every lab will write its own standard operation procedure (SOP) for testing which should address such matters. I cannot say whether K should or should not be excluded if not homozygous; it's really up to the SOP. If you are in an MLT or MLS program, ask your instructor about ways to handle ruling out low-incidence antigens.
@@patricktracy9947 Thanks for the response! I meant low incidence by the way, not prevalence. Also, the textbook is by Denise Harmening.
@@zucccccc7467 One thing to note, even though the K antigen doesn't appear often in a typical antibody identification antigram, I wouldn't really consider it as low-incidence. It is usually present in at least two cells, whereas Lutheran-a usually doesn't appear at all.
Thank you for this. In 3 years of my work, we never do antibody panel testing. I’m a bit confused - why was Jsa not crossed half? Thank you again!
I am also wondering this, i presume it's a mistake by the person performing the screen.
I gave Jsa an X and completely ruled it out because it is a low-incidence antigen. There are different ways to approach ruling out antibodies with some being more conservative than others. If I were to be very conservative, I would not have completely ruled out Jsa, but would have done further testing to completely rule it out. If this patient were to receive a crossmatch which turned out to be incompatible, then I would return to the antibody identification panel to see if a low-incidence antigen like Jsa were the issue.
That was so helpful thank you!!
Good, that's the point!
mind asking, at panel 11, the JSa was (+ve) and JSb (+ve) so both was heterozygous isnt it? but why does the JSa were not single cross (/) at panel TC?
I was wondering the same thing
Thank you so much! this was so so helpful :) ive always tried to figure this out now 4 years later i get it!!
Better late than never. :)
Very informal. Thank you.
Very helpful. A big THANK YOU for the video.
You're welcome.
Why is big M for donor/row 3 heterozygous? There's only M, not big M little m. Shouldn't it be homozygous? Ugh I am so confused.
Hi opiumden, the most common pairs that are used for determining dosage are Ee, Cc, Kk, JkaJkab, FyaFyb, MN and Ss although these are not the only pairs you need to pay attention to. As you can see, there is no m. M is paired with N. That is why M is heterozygous.
thank you so much
Thank you so much Doctor for the great explanation. Can you do more vedios on discrepancy
Hopefully, but not anytime soon.
This was huge help. Thanks!
You're welcome.
17:05 rule of three
this made things easy for me ......thank you
Hi Petronila...I am glad it was helpful. 😁
thanks for this video highly appreciated, by the way, im a volunteer trainee at a component processing unit, I wonder if panocell is used for tube method, because I saw my staff also doing an antigram of Panel C, using gel card method, p.s. they're using OrthoInnova/ OrthoMax Vision machine, if ever in the future also make a video in terms of gel card and automation.
thanks again! looking forward for more educational and informative tutorials, you inspire us a lot. God Bless.😇
I don't teach anything in our student lab except the tube method...sorry.
Sir, we request you to kindly make videos on adsorption and elution procedures! ❤️❤️
Hi Azadar,
I do not teach those techniques in my program, so I am not familiar with doing them.
@@patricktracy9947 BTW thank you sir for all these wonderful videos ❤️
Sir which book we should use for microbiological techniques and for blood bank? Kindly, guide us.
i dont understand, why does Big M was heterozygous and it should be given single cross at first? more confusing, it gets homozygous and double cross then. do you mind explaining it?
Hi,
M is heterozygous because MN is a pair not Mm. This is a unique group of antibodies-MN Ss. You can also read the previous comments for reference where the lecturer points that out.
Thanks Jule :)
Helpful video. Thank you so much!
You're welcome.
this is how I do my cross out...it's quite different how blood bank guy does it...his double dosage is quite questionable.
Thank you soooooo much!!! You saved me indeed
Wow! I am glad I could help.
Thank you so much for this video. I know how to cross out but after finding the antibody I don't know what to do. I don't know if I was doing the rule of 3 right.
Hi Fritz, applying the rule of three can be a bit tricky, especially for confirming the three positives. I could Zoom with you and explain it if that would be helpful.
You mentioned some antigens are low incidence. Which ones are the low incidence?
Look at the antigens that have all 0's or just one or two +'s.
Really thank you great effort and great job ...appreciate!!!!!
You're welcome Amrou.
Thank you 🙏🏾
Hi. Hope you're having a good day. If I may ask, what does the IS phase stand for, initial or immediate spin? Or is it the same?
Hi, yes IS stands for immediate spin, which really is the same as initial spin, so they are the same.
Thankyou , its really informative
You are most welcomed.
Hello! I have a question. During the antibody screening, will you consider significant antibodies that showed little dosage? Loved your video btw, I always use it as reference
Why didn't you half-crossed the Js^a? It gave a positive reaction on the 11th cell which is a heterozygous
Hi Meriam,You are right; I should have put a single slash through Js^a. This will not affect the outcome of the panel. This also illustrates how easy it is to make an oversight on all these little boxes.
Patrick Tracy even though you didnt put one slash on that antibody, it was quite understandable that it was not ruled out. Thanks by the way! Great lecture 😃
Thanks, I am glad it was helpful.
I look for easy procedure for cross matching
Do you need to use donor cells to do Ab identification for patient? Or just the company reagents (11panel)!? Because on the left i see (Donor) written over there
The antibody screen and panel reagent cells are labeled as "donor" because the RBCs in the reagent come from human donors. Do not confuse them with a donor of a unit of RBCs.
@@patricktracy9947 yes now i understand, thanks ❤️🌹🌹
You haven't single crossed "Jsa" yet it is homozygous in TC. Do we not take TC into consideration. Please help I am dumb 🗿
Hi kk...your observation is correct, and I address it in the notes section.
Thank you for your video. it is very helpful!
My pleasure
Is alloantibody screening must or optional before transfusing PRBCs? And after TYPING what's the rationale behind doing antibody screening with blood type O first rather than directly going for cross matching between patient serum and sample from actual PRBC unit we're gonna use?
Theoretically, the antibody screen is not needed, but I don't know of any blood banks that would not do it. The screen may detect antibodies that may not be detected in the crossmatch.
I think C.M is the final check for ABO compatibility. Now if the patient is having weakly reactive alloantibody( Let say it anti-jka) and donor is heterozygous for that antigen[ jk(a+b+)] then in cross match the alloantibody may not be detected( because few antigens are available for weakly reactive Ab) but on screen it should react because screen cells are homozygous[ jk(a+b-) ]for the antigen( all the antigens are jka on screen cells)
We use 'O' cells in Ab screen because they don't have A or B antigens and don't react with anti-A or anti-B antibodies of patient and only detects non ABO antibodies.
Sorry for the bad English 😂
is there sufficient evidence to prove the suspected antibody or Is the patient lacking the antigen corresponding to the antibody?
First of all, in order for a person to produce an antibody targeted at RBCs, they MUST lack the corresponding antigen. Second, the antibody identification method used in this video is routine and would be reliable in most situations. There was nothing out of the ordinary with this patient, so yes I am confident that there is sufficient evidence.
In addition to the rule of three, do you confirm your antibody using antigen typing or not ?
and
what source do you use to confirm your antibody?
With this patient, we did not use antigen typing to confirm the antibody. Under normal conditions, we wouldn't do that. We mainly do antibody screening and identification to support crossmatches. If for some reason an antibody went undetected in the screen or was misidentified, it should be detected in the crossmatch if the facility has a crossmatch procedure which uses the indirect antibody test with anti-human globulin.
Well thank you so much- your information helps me to improve my research. All the best
Thank you so much! Great job
I'm glad it was helpful.
Thank you this helps a lot!
I am glad it was helpful.
Hi sir my doctor told me to identify the agenest antibody wt can I do it's curable to medicine
Hi Gous, I do not understand your question.
Thank you so much! 😁👌
I hope it was helpful.
Hi, so i know some people put a scribble for kell to differentiate big from small. Does the scribble mean big K?
Sorry, I am not sure what you mean by scribble. When writing antibodies big C and little c, we put a line over the top of little c to make sure it is not confused with big C. For big K and little k, there is a slight difference in how they are written to indicate which one is big and which one is small. I cannot show you here, because I can only type.
Thank you so much 🦋🦋..
You're welcome.
I was shown this years ago on a path placement brill vid xxx
Thanks Dan
Why isn’t Jk crossed out in technical cells (Kell column)? It was positive and by itself...
I don't respond to questions that are inaccurate. There is no Jk in the Kell antigens listed on the antigram.
Patrick Tracy It was a typo. I meant Js under Kell antigens in technical cells. It was positive and by itself so wondering why wasn’t it crossed out?
@@annaly6612 Again I have incomplete information. You refer to Js. Is that Jsa or Jsb? The reason I am being particular about this is because it seems like you are not closely paying attention, and that is what causes mistakes.
I liked your video a lot. Am I wrong that Lea and Leb are not alleles? Wouldn't it better to use a different strategy to rule them out?
Hi Paolo, do you mean that Lea and Leb do not exhibit dosage?
Kelly doesn't show dosage, neither does Lutheran.......or lewis........yet u cross out in a way tht suggests tht they do.....eg: u could have fully crossed out the Lutherans at cell 8 yet I'm seeing a single cross through Lutheran a
I am just being conservative. Some blood bankers believe all antigen pairs should be treated as if they exhibit dosage. It's better for students to learn a cautious approach. When they are certified techs working in the field, they can expand their approach to blood banking while in the confines of the standard operating procedures of the lab they work in.
Can you please do a vedio on discrepancy. Thank you so much
Maybe in the future.
Thank you so much for your video. I have got everything)).
Coolio...thanks
Is there a reason y u cross out tht way?
wow I love` it
I'm seeing this to learn for Licensure exam.. please tel how homozygous and heterozygous understands?? ..
I recommend the following links.www.bbguy.org/education/glossary/gld15/www.bbguy.org/education/videos/antibodyid1/
thank u for this video
Hi Astrud...I am glad that the video was helpful.
10:03 why didnt you totally cross out the M?
Because it is heterozygous with N. I only completely cross out an antigen with an X if it is homozygous.
10q........it is really helpful
Thank you...I am glad it was helpful.
I love you
it's like calculating lottery number
Yes, something like that. :)
Sir looking for blood bank job.i have 5 years of experience.can you help me?
I really don't know what I can do for you.
can you help me with my transfusion assignment?
if yes please send me your email
ptracy@wvc.edu
bruh