Much as I do like the gel technique (we use DiaMed in my laboratory) I think that they are very sensitive at detecting such antibodies as anti-McCa, anti-McCc, anti-Kna, anti-Yka, anti-Csa, anti-Bga, anti-Bgb, anti-Ch, anti-Rg, etc. We are detecting many more of these (and I do mean many) than we used to when we were using tube or liquid-phase microtitre plate techniques. I suspect that manyof the reactions being seen "at the hospital level" (and I do not mean that to sound disparaging) are of this ilk. In most cases, I suspect, hospital-based laboratories will have neither the time, nor the reagents to sort these out (although they would certainly have the expertise). The lack of sufficient reagent red cells may also be true for many Reference Laboratories. In cases where the reactions are 1+ in gel with some panel cells, but weaker (0.5%+ !!) with others, but the auto was quite clearly negative, we will often "diagnose" these as anti-CR1-related, without assigning an actual specificity. On other occasions, if we find nothing by tube IAT, we will put out a report saying that there is nothing there (on the grounds that there are no clinically significant atypical alloantibodies detected). I suspect that this may be part of the problem, but I think that there is more to it than just this explanation. :confuse: