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Gel likes colds, the larger IgM antibodies are more easily trapped in the columns matrix. You can only really identify cold antibodies with specificity (lots of anti-M) using Gel. For Panagglutination in screen, panel or a discrepant back type we resolve using tube.

Anti-M comes to mind most often, esp w Ortho gel cards.  It is possible to work up cold abs.  I've used the buffered gel cards to do so.   I've also used 2 stage papain pretreatment of panel cells (in gel). 

Same here.  It wasn't that long ago when Electronic XM's weren't a thing. I find it so amazing how far technology has "improved" blood banking in a relatively short time.  

Hi Malcom, I attended your presentation on ABO discrepancy. Thank you, it was a very informational presentation! Thumbs up! 

"Do you perform all the antigen typing on your cord samples so you know which ones to use?!"
 
Yes, we now actually use a four cell panel of frozen cord cells that last about a month in Alsever's solution once thawed.  We select cells so we have appropriate negatives and positives for the most important clinically significant antigens. We don't concern ourselves with Lewis, P, etc.  We do a full phenotype on the selected cells we use. Labor intensive but otherwise inexpensive.  

If you have access to cord red cells from your OB service, these are negative for CD38,  and we use a panel of three of them to rule out alloantibodies when patients are receiving daratumumab(Darzalex). 
  Transfusion . 2015 Sep;55(9):2292-3.  doi: 10.1111/trf.13174.

A few things as far as human reagents.
Firstly, you never know what else may be in them in terms of antibodies directed against low prevalence antigens, because there is absolutely no way that the producer has the ability to test for all such specificities (I can remember once a human-derived anti-D reagent produced at one of the places I worked, also had a Gm antibody in it that we didn't know about.  It is highly unlikely that this would have caused too many problems, but there is, nevertheless, a small chance that this could have caused a false positive).
Secondly, you never know what else may be in them in terms of viruses, some of which may, as yet, be unknown to us (remember, HIV, used not to be known).  This is a danger to the producer and the person using the reagent, rather than the patient.
Thirdly, the avidity of human reagents is, in general, pretty poor (particularly anti-D).
A few things concerning monoclonal reagents.
Some of them cross-react with other specificities (although not many), but, famously, monoclonal anti-D reagents will react with the I and i antigens if used straight from the fridge.
They have to be blended by experts to ensure that the desired epitopes are detected, but certain Partial D types (e.g. Partial D Type VI) are not detected (unless required).
They are very specific and very avid (both of which are greatly to be desired).
Virally, they are almost certainly sterile.
Hope that helps.

It is, nevertheless, true.  
Thorpe SJ, Boult CE, Stevenson FK, Scott ML, Sutherland J, Spellerberg MB, Natvig JB, Thompson KM.  Cold agglutinin activity is common among human monoclonal IgM Rh system antibodies using the V4-34 heavy chain variable gene segment.  Transfusion 1997; 37: 1111-1116.
Thorpe SJ, Ball C, Fox B, Thompson KM, Thorpe R, Bristow A.  Anti-D and anti-i activities are inseparable in V4-34-encoded monoclonal  anti-D: the same framework 1 residues are required for both activities.  Transfusion 2008; 48: 930-940.

Also, the polyclonal (human) reagents will give false pos results in samples with pos DATS.  But anyway, finding sufficiently good human antibodies to manufacture reagents from is getting harder and harder.  So definitely monoclonal

Welcome COWEN4.

If IS XM can be a test on the Vision, I would think it could go through the interface like the AHG XM does.  Might depend on your BBIS.

So will I.  I was never great at chemistry!

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Aww I failed 😞 
 

We have for IgG XM but not IS.  The latter is very fast in tube and we don't do it except during computer downtimes and some rare occasions.  We use the electronic XM for most.

Finding and retaining competent blood bank techs post-Covid has become a real challenge. We have lost so many techs to retirement or travel agencies that it has created a logistical nightmare staffing the blood bank 24/7. There just aren't enough techs to go around. Those still working are all close to retirement (myself included) and are all burnt out. Is anyone else experiencing the same issues?
The looming lab staffing crisis is now upon us. Help!
 

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Do keep us updated.  I am sure we are all looking forward to news of a healthy baby

I very much appreciate you taking the time to answer my question, and in such a detailed, but still easily understood manner.

Thank you very much Neil.

Each reagent requires QC on day of use. We had multiple reagent racks of our routine antisera at our facility. We rotated the racks for QC so that each rack would be QCd  once or twice per week depending on how many racks were in use.  Each rack was checked daily for lot confirmation and expiration date.  QC for special antisera was performed on the day of use as required. I believe that the question did not offer all of the options that are required to answered correctly, in my opinion. 

A few of our newer employees state that their previous employers had required this, but I had never heard of this.  We were trained by our ortho rep back in 2005 or so to pipette straight up and down for both reagent cells and plasma.  My question is since many labs are automated for blood bank now, how do the analyzers pipette the samples.  Is there an air gap in the testing with the Provue or the Vision? 

From reading the previous comments, both old and new, it appears that the manufacturer (Ortho) does not specifically require the bubble and therefore nothing is in writing (the Directions for Use). You may be out of luck trying to find something to reference.