26 - Labex

Case Study (continued)
The antibody was reactive with selected
cells negative for the following antigens;
Vel, Yt a , Jr a , Ch a , Kp b ,Tj a , Ge2, Cr a , Rh null,
Cromer null.
The woman had been pregnant twice
before, but the father of this baby was
different from the father of the previous two
children. The maternal serum was reactive with
the paternal cells as well as with cells from her two
sisters.
As this was a case of an antibody to a high-frequency
antigen other than those already investigated, the
sample was referred to the Swiss Red Cross at Bern
for further investigation. The serum was found to
contain anti-Wr b with a titre of 2000 in the ID-System.
The patient’s cells were found to be Wr(a-b-), a very
rare phenotype associated with certain rare MNS
types, involving hybrid glycophorins that lack the
part of GPA that reacts with antibodies known as
anti-En a FR.
The association between Wr b and MNS was first
demonstrated by Issitt et al. when he found that En(a-)
News
Many of our customers
will remember Pascal
Gauch who worked at
DiaMed AG for 8 years
until October 2001.
Pascal acquired experience
in International
Marketing for Medical
Devices whilst employed
in the Bern region of
Switzerland for a com-
Transfusion Science Courses: 10 Years On!
The present format of these courses, held three
times a year, began around 10 years ago and have
remained well-attended each time. DiaMed AG is
the only commercial company to provide altruistic,
non-commercial educational opportunities for dele-
cells were Wr(a-b-). Subsequent studies
suggested that the Wr b determinant
is located on GPA, but it was known that
Wr b is genetically independent of MNS.
The Wr a /Wr b dimorphism results from a
single amino acid substitution within band 3,
which carries the antigens of the Diego
system. Thus, in 1995, Wr a and Wr b were assigned
to this blood group system, but Wr b can only be
expressed when band 3 is associated with GPA in
the membrane. In this case, the patient’s cells may
be Wr(a-b-) due to homozygosity for the GP.Hil
gene (MiV/MiV), originally described in a Spanish-
American woman, or to heterozygosity for the
GP.Hil gene and Mk. Mk produces no M or N and
is also silent at the Ss locus. The proposita in
this case, these typing as M+N-, S-s+ could therefore
be expressing only a single dose Ms.
Although compatible blood is extremely difficult to
find, generally anti-Wr b does not manifest clinical
HDN and so the baby may be born with cells sensitized
with the antibody (DAT positive) but is unlikely
to require transfusion. The samples were referred
to the IBGRL in Bristol, UK, for further analysis.
pany that manufactures hearingaids. We are now
delighted to announce that Pascal has rejoined
the company, as European Business Manager with
special responsibility for assisting our distributors in:
• France • Greece • Scandinavia
• Italy • Portugal • Eastern Europe
• Ireland
We would like to take this opportunity to welcome
Pascal back into the DiaMed family!
Pascal can be contacted at: p.gauch@diamed.ch
gates from all over the world. The speakers that
have been involved over the years reads like a
“who’s who” in Transfusion Medicine and the quality
and value of these courses have been recognized by
an award from the ISBT. Many of the lecturers return
5
Transfusion Science Courses: 10 Years On! (continued)
time after time to contribute with their expertise in
promoting high standards in immunohaematology
and safe blood transfusion. These include such wellrespected
figures in our field as Professor Marcela
Contreras, Professor John Barbara, Professor Dave
Anstee, Dr Geoff Daniels, Professor George Garratty,
Ms Joyce Poole, Dr Martin Olsson, Dr Urs Nydegger,
Dr Peter Issitt and many more, too numerous to
mention here.
It is estimated that to date, up to 2000 individuals have
participated from countries as diverse as Costa Rica
and Finland, Senegal and Switzerland, with almost
every country in the world being represented at some
time. This means that the messages and knowledge
imparted during the courses can be disseminated
and provide a basis for action in Transfusion Science
and Medicine in order to influence practices with
the aim of ensuring safe transfusion therapy globally.
The courses are fully supported by DiaMed AG and
no tuition fees are payable by participants. For this,
a debt of gratitude is owed to M. Jean Adam, CEO
of DiaMed AG and, of course, to the eminent speakers
who give of their time for the purpose of quality
education.
In June, the second transfusion science course was
held at Cressier. The course provided a wide range
of transfusion-related topics, including immunohaematology,
haemostasis, transfusion transmitted
diseases and various clinical aspects of transfusion
medicine. The programme consisted of the following
lecture titles:
John Barbara
• Blood Transfusion: the Ideal Portal of Entry
• New and Emerging Agents
• Transfusion Infection Risk: Ideals and Realities
• Prions: the Ultimate Transfusion Risk
Marcela Contreras
• Alternatives to Allogeneic Blood Transfusion
• Blood Transfusion in Patients Undergoing Haemopoietic
Stem Cell and Solid Organ Transplantation
• Universal Leucodeplection and Some Immunological
Complications of Blood Transfusion
• Cord Blood Banking and Transplantation
Hans-Jürgen Kolde
• Platelets: Key Players in Haemostasis
• The Modern Concept of Cell Based Haemostasis
• Methods for Platelet Function
• Haemostasis Testing and a Targeted Transfusion
Strategy
International Exhibitions and
Congresses with Participation
Date Event
3.9.2005 – 7.9.2005 ESC Congress
European Society of Cardiology
www.escardio.org
Stockholm, Sweden
6.9.2005 – 9.9.2005 DGTI
38. Jahreskongress
der Deutschen Gesellschaft
für Transfusionsmedizin
und Immunhämatologie
www.dgti.de
Erfurt, Germany
11.9.2005 – 15.9.2005 World Congress
for Tropical Medicine
www.iftm-pharo2005.org
Marseille, France
15.10.2005 – 18.10.2005 AABB American Association
of Blood Banks
www.aabb.org
Seattle, USA
25.10.2005 – 27.10.2005 Medic Africa
www.fsg.co.uk/index.htm
Zambia, Africa
12.11.2005 – 15.11.2005 ISBT XVI International Society
of Blood Transfusion
www.isbt-web.org
Bangkok, Thailand
16.11.2005 – 19.11.2005 Medica 2005
www.medica.de
Düsseldorf, Germany
3.12.2005 – 6.12.2005 ASH American Society
of Hematology
www.hematology.org
New Orleans, USA
Take the opportunity and visit one of our stands.
Imelda Bromilow
• Challenges of Blood Banking
• Clinical Significance of Antibodies and
Haemolytic Transfusion Reactions
• Fetal and Neonatal Blood Transfusion
• Direct Antiglobulin Testing
• Quality Assurance in Transfusion Science
• Case Studies and Interactive Session
The next course will host Professor George Garratty,
Professor Dave Anstee and Ms Joyce Poole as guest
speakers.
•I. Bromilow
6
26
Alan Lawson (DiaMed-GB)
Imelda Bromilow (DiaMed AG)
Katie Balmer (MHRA)
Jenny White (NEQAS)
Some of the participants
Summer edition © by DiaMed AG Tel. (+41) 26 674 5111
CH-1785 Cressier sur Morat Fax (+41) 26 674 51 45
Distributors’ News – DiaMed-GB
DiaMed-GB hosted a “Users’ Group” meeting at the Marriott Hotel,
Heathrow earlier this year. The meeting took the form of a series of
presentations of interest to ID-System Users, with a closing discussion
period. The morning session was opened by Mr Alan Lawson, MD,
of DiaMed-GB, who welcomed the 150 participants to the meeting
and promised them a very interesting day, examining various issues
facing both suppliers and users of diagnostic products.
The first presentation, by Imelda Bromilow of DiaMed AG, reflected
on how much things have changed from what some perceived as the
“Good Old Days” before the stringent regulations that are now required
to be observed, both by producers and users of laboratory diagnostics.
This was emphasized by the next speaker, Katie Balmer from the Medical
and Healthcare Products Regulatory Agency (MHRA). Katie explained the
process of IVD Incident Reporting and the subsequent investigations on
any device involved in an adverse event, such as misdiagnosis or inappropriate
treatment of a patient. The resulting outcome may be a “medical
device alert”, a product recall or in certain cases, regulatory action.
Jenny White, Deputy Scheme Manager for UK NEQAS (BTLP), covered
the choice and risk assessment of ABO/D grouping reagents and profiles.
NEQAS exercises have shown that there remain serious shortcomings
within the laboratory service, particularly regarding techniques and
reagent choice. Learning from these exercises is vitally important to
ensure safe transfusion practice and Jenny’s “take-home message”
to the participants was “never compromise patient safety”.
After lunch, the afternoon session, entitled “A Glimpse of Things to
Come” began with a presentation by David Bashforth of DiaMed AG,
revealing a novel approach to the IAT in the ID-System. Although still
in the Research and Development stage, initial results from external
evaluations have shown that it is possible to reduce the time required
for testing, without compromising sensitivity or specificity. Once available,
after CE marking and registration are complete, this “fast” test
will be of value in emergency situations, enabling samples to be tested
and blood selected within a very short time.
The session continued with Ian Ogden from DiaMed-GB presenting
further innovations, this time regarding the automates ID-GelStation
Classic and ID-TwinStation Techno. With more than 200 instruments
placed in the UK, these latest improvements to both hardware and
software mean that DiaMed can provide robust, user-friendly analysers,
incorporating the latest WLAN (wireless connectivity) technology.
The final speaker was Armin Köchli from DiaMed AG, who presented
the next generation of antibody identification software, which is
currently in field trials.
The open forum discussion proved to be lively and interesting, with
many subjects debated. These touched not only on the presentations,
but also on issues such as neonatal testing and quality assurance. In his
closing remarks, Alan Lawson emphasized that DiaMed continues to
strive to improve systems, with the aim of ensuring transfusion safety.
H005373 09.05 NEWS, COMMENTS, SUGGESTIONS for future editions are always welcome.
Please send/fax/e-mail copy to Imelda at i.bromilow@diamed.ch,
fax: +41 26 674 56 45, 1785 Cressier, Switzerland
1

Distributors’ News – DiaHem (Poland)
A national conference was held in Warsaw, Poland,
for around 100 transfusion specialists, in May of this
year. Professor Barbara Zupanska, a very well-known
figure in the world of blood transfusion, introduced
the speakers for the afternoon session (see photo).
The symposium was entitled “Immunology of the
Red Cell: Theoretical, Diagnostic and Clinical Aspects”;
many of the lectures reflected on themes concerning
the EU Directive, particularly as Poland is now subject
to European rules and regulations. The second
photograph shows the participants in readiness for
the afternoon session!
Distributors’ News – Mirr Sci Tech Corporation, Korea
The Hotel Tirol in the Muju Resort of South Korea
was the setting for the annual meeting of the Korean
Society of Blood Transfusion in May this year.
The evening of May 19 th provided an opportunity
for a special seminar for members of the Transfusion
Cats and Dogs!
No, we are not talking about the weather, but
DiaMed’s first venture into the field of laboratory
testing for animals with DiaMed-VET products.
In June, representatives of DiaMed attended the American
College of Veterinary Internal Medicine Forum
(ACVIM), Baltimore, USA. This prestigious event was
attended by several thousand veterinary surgeons
from all over the world and it was for this reason that
Medicine Study Group and the days were filled with
a very comprehensive and international programme.
Professor Seog-Woon Kwon, MD, the Blood Bank
Director of Asan Medical Centre, in his role
of Scientific Director of the KSBT, ensured that there
were lectures of interest to all delegates.
Mirr Sci Tech Corporation, the DiaMed distributor
in Korea, exhibited the new ID-TwinStation Techno
and had a large team on hand to demonstrate
the automation and liaise with customers.
The Muju Resort is a ski region in South Korea,
about 3 hours from Seoul and the Hotel Tirol a perfect
replica of any to be found in Austria. Although it
was not the ski season at the time of the conference,
participants could be forgiven for thinking that they
were indeed in the Austrian Tyrol, complete with a
German “willkommen” message to guests in
the reception area!
DiaMed chose this venue to launch its new range
of DiaMed-VET products.
Initially, this is limited to ID-cards for grouping cats
(A, B or AB) and for the detection of the dog erythrocyte
antigen (DEA) 1.1. AB grouping in cats is
important in both pre-transfusion testing because
of the presence of naturally occurring antibodies and
in breeding programmes as a predictor of neonatal
Cats and Dogs! (continued)
isoerythrolysis (sick kitten syndrome). Whilst dogs
do not have naturally occurring antibodies, they are
prone to producing alloantibodies. Although several
antibody specificities have been identified, the DEA
1.1 antigen is generally considered to be of most
importance, transfusion of antigen positive blood
against the respective antibody being life-threatening.
Though less advanced than transfusion medicine in
David Bashforth, Isabelle Delafosse and Ron Orynich
humans, it is fast gaining momentum in veterinary
medicine with several papers being presented at
the ACVIM and much interest being shown in the
new DiaMed cards. Anti-canine and anti-feline globulin
cards are soon to be released for crossmatching
in both animals and for direct antiglobulin testing
which is highly important in the dog due to the high
incidence of haemolytic anaemias.
For those readers with more interest in this subject,
there are two papers published in the August edition
of The American Journal of Veterinary Research
which review the performance of our two cards:
AJVR, Vol 66, No. 8, August 2005:
Comparison of various canine blood typing methods.
Urs Giger, PD, Dr med vet,
Knut Stieger, Dr med vet,
Hanna Palos, DVM.
AJVR, Vol 66, No. 8, August 2005:
Comparison of various blood-typing methods
for the feline AB blood group system.
Knut Stieger, Dr med vet,
Hanna Palos, DVM,
Urs Giger, PD, Dr med vet.
Distributors’ News – DiaMed-Czech Republic/Slovakia
During June of this year, the Haematology and
Transfusion Society of Slovakia hosted ˆ
a Transfusion
conference in Cilistov under the auspices of the ˆ
conference
President, Dr D. Holománová.
The 3-day programme covered many important issues
facing transfusion specialists, including Information
Systems, component therapy, immunohaematology,
transfusion reactions and transfusion transmissible
diseases to mention just some of the topics covered.
The meeting took place in the Hotel Kormorán and
the DiaMed team had a stand exhibiting the Swing
pipetting automate instrument which generated
a lot of interest.
The DiaMed distributor, Eurex Medica, was one of
the main sponsors of this meeting. The conference
dinner was also held at the same hotel and was
enthusiastically attended by all participants!
ISBT Athens, Greece
The XV th Regional Congress of the ISBT, Europe
was held from July 3 rd to July 6 th in the International
Conference Centre in Athens. The opening ceremony
was held in the Concert Hall and following the opening
remarks, the participants were treated to a concert
featuring the music of Mikis Theodorakis. The music
was enhanced by film excerpts from some of his wellknown
works, the most famous being Zorbas (Zorba
the Greek), which had everyone clapping along!
DiaMed AG had a large booth in order to display
a complete range of instrumentation (see photos).
Representatives from DiaMed-Hellas, DiaMed-Italiana,
DiaMed-Deutschland GmbH, DiaMed-GB and DiaMed-
Österreich as well as from the Swiss headquarters,
were available to demonstrate the equipment and
answer customer questions. The new “Impact” and
“Impact-R” for platelet function testing were displayed
and interest in this technology was high.
The hand-held DiaMed fans were a welcome “giveaway”
for cooling down in the Greek sunshine!
DiaMed also sponsored the congress bags (see photo).
Impact technology Some of the many visitors to the stand
Case Study
The DiaMed booth ready for the opening
Conference bag, sponsored by DiaMed
Techno and Classic Automates
Swing and Jive Instruments
Antibodies to high-frequency antigens are probably the most
problematic for many reasons.
A sample from a 24 week pregnant woman presented the following
results:
Group 0 RhD positive, probable genotype DCe/cde (R 1r), MM, ss,
K-k+, Jk(a+b+) and Fy(a-b+). Her serum was positive with all cells
at 37 °C, by enzyme-treated cells (ETC) and in the Indirect Antiglobulin
Test (IAT). The autocontrol for each technique was negative.
2 3 4