Issue link: https://ahint.epubxp.com/i/574474
14 ASHI Quarterly Third Quarter 2015 E D I T O R I A L learned is that a person is never too old or experienced to learn and never too young or inexperienced to teach One of my most influential experiences occurred on a Friday evening I was performing a flow crossmatch for a patient who was going to be receiving a heart that night Her most recent FPRA (a month previous) was negative for Class I and she had a negative virtual crossmatch Unfortunately, upon performing the crossmatch on her pre-transplant sample there were strong T and B cell channel shifts Additionally, that sample also showed 100% sensitization to Class I This was such a surprise I spent the better part of the night repeating tests on alternate samples in the lab, obtaining pre-transplant samples from the various laboratories at NMH to confirm that there wasn't a sample mix- up, and communicating with my supervisor late into the night As it turned out, there was no sample mix-up (confirmed by re- typing all the patient samples) and this ended up being a very interesting case What this meant for me was that my efforts helped the transplant team act quickly and provide appropriate treatment to prevent rejection I considered it an honor and a privilege to participate in this case and offer my services I was in the lab a very long time that day, but I wouldn't have traded it for anything There was nowhere else that I would have rather been at that moment I truly knew at that point that this was my calling I am currently participating in a research study that is examining the ability of various assays to accurately monitor the effectiveness of antibody removal therapies This study involves 47 patients and approximately 125 samples In addition to a C1qScreen, each sample requires One Lambda LABScreen single antigen testing (with titers) When complete, this entire study will amount to well over 1000 single-antigen tests I am the sole person tasked with running these samples, and I am humbled by the fact that my director has entrusted with me such a great responsibility It has been a rewarding challenge to find the balance between my clinical duties and my research responsibilities, but I believe that I have handled it exceptionally well It would, however, be unfair of me to take credit without acknowledging my amazingly accommodating flow cytometry team I love working in an HLA laboratory There is really nothing more satisfying than hearing of a successful KPD, or running a final crossmatch that turns out to be negative One of the reasons that I am so passionate about flow cytometry is because I feel that we have a special bond with the recipients Even after a successful crossmatch is completed, we may very well be monitoring that patient for life Twenty years from now I hope to see familiar names still negative for DSAs In a way, we technologists can celebrate with them I truly feel that there is a silent dignity associated with watching over a person's well-being when that person doesn't even know I exist What higher, more noble, calling could there be? It seems like there is never a shortage of interesting cases in the flow cytometry laboratory Just a few weeks ago we had a patient with a Bw6 antibody that really caused some initial confusion The patient had a FlowPRA of 85 percent, but only a few weak antibodies and Bw6 stacking near the threshold (most likely due to a dilution effect) A surrogate crossmatch against a homozygote Bw6 was positive and led to the conclusion As scientists, we can't help but get a little excited when something really perplexing, unique, or different comes along It's nice to get a break from the normal, but one of the most important lessons that I can pass on to anyone willing to listen is that nothing is truly normal about what we do To the patients and their families, the "big case" is their case To a recipient, there is nothing routine about a routine biopsy Every time we test for donor specific antibodies we must remember that there is a recipient on the other end that is probably scared or anxious about what the results might mean for them As an HLA technologist, it may be difficult to connect to the people you are serving; however, it is imperative that we remember that each clinical sample is a unique individual This has an even deeper meaning in transplant surgery because of the fact that we're also dealing with donors Deceased-donor organ donations are precious gifts that require a devastating loss of life before they are given Living-donor donations are selfless, altruistic acts of kindness A profession like ours requires a very special mindset We must be the exemplification of respect, sensitivity, empathy, and service At first glance, these words may seem like nothing more than a cliché hospital mission statement, but at the end of the day this philosophy is dear to my heart I speak these words with conviction because I know from personal experience the hardships and joys that come from an organ transplant When I'm comforting my wife because her mother's creatinine is once again above the normal reference range, I can't help having a special appreciation for the "normal" day-to-day work we do Nothing could be more important, and this is why I want to devote my life to this cause and to the people it serves I am eager to get my CHT certification at the next available opportunity and I am excited to become more involved with ASHI and network with other professionals I truly look forward to what the future of this field holds for me Corresponding Author Information Comprehensive Transplant Center Northwestern University Chicago, IL 60611 One of the reasons that I am so passionate about flow cytometry is because I feel that we have a special bond with the recipients. Even after a successful crossmatch is completed, we may very well be monitoring that patient for life.