MEVANS

Hello, Our facility has been using the Echo for about 5 months, in recent months we have had issues with the Select plate for AHGXM. Immucor has distributed a communication that they are aware that sometimes a screened unit is giving an unexpected positive result with the Capture-R Select. We have had 5 such patients, antibody identification is complete, units are screened but crossmatch is incompatible. We have checked the units for positive DAT, re-checked the antigen testing and sent some of the specimens to Immucor (which repeated the same on their analyzers). The AHGXM was performed in gel and tube for these patients and found to be negative. During validation of the Echo and since we have detected antibodies that were not seen in gel or tube. I am reluctant to just perform AHGXM in another method without using the same method that was used for antibody identification. At the same time Immucor is aware there is an issue and we are wasting time screening additional units that will potentially be compatible in their system. How are others dealing with this issue? Thank you.

I used the cart they recommended in their paperwork, found at Bench-Craft (www.bench-craft.com). Immucor recommended 30W X 48L X 36H, it has locking wheels and the Echo fit great. We haven't had any problems with it moving and when we want to get behind it we can unlock the wheels easily. Hope that helps!

We just recently switched from gel to Echo at our facility and our routine practice is to run a DAT (IgG, C3b and autocontrol) in tube and then confirm the IgG portion on the Echo. We had a debate when we were still routinely using gel about running an autocontrol or DAT (IgG). We ended up using the MTS IgG card for the DAT (IgG) confirmation of our tube method after we had missed a few very weak IgG reactions in tube only method. My confusion regarding the idea of an autocontrol in gel is that it seems like it is just an autocontrol of your patient in that method vs. a strict autocontrol in tube method. If your using the MTS IgG card the Anti-IgG could be trapping IgG from the patient's plasma or coating the cells....??

How does your facility document that the physician has provided informed consent? Our patients sign a consent form that meets all the requirements outlined by AABB but during a review for Joint Commission we were cited for not having documenation in the medical record that the physician provided the discussion. Any ideas...

We have been having a problem with the cards for about 2 years now. Sometimes centrifuging helps and sometimes not. We have requested several replacement shipments during this time. A specialist did come to our site and agreed that a number of the cards did not meet the requirements in their own guide for visual inspection criteria, later after taking some of our cards to a technical meeting it was concluded that the lighting in our lab is why we we're seeing the gel or liquid above the liquid level and it was fine to use the cards...

Our facility also has nursing provide a slip with patient name and medical record number (generally the blood product numbers are included as well) and we store these for two weeks. I have only needed them when someone has not filed the information in the computer system (not to often). As stated earlier I believe the standard is referring to the physician's request for blood products. At our facility this is in the patient's medical record and entered in our computer system which meets the five year requirement.

We culture from the remaining port as well, and we try to use blood culture bottles if there is enough blood left but if not we use thio broth for 5 days and then sub for two days.