cplatt36

You could test the patient using PEG. Instead of solid phase or gel. I have seen many E's be picked up using PEG tube and missed with solid phase or gel.

Question is the autovue replacing the Pro-vue?

It all depends what values you are looking at and if the specimen is collected from the oposite extremity of the blood product transfusion. Technically you should wait 1 hr for the blood products to reach equilibrium.

Actually all you have to do is add your enhancement solution once converting 0.8% to 3%. After concentration you can use what ever enhancement you want. 2 drops LISS, PEG, Albumin, NISS, so it is not about the enhancement, you add that to your cell solution. 2 drops patient plasma, 2 drops enhancement. Not to mention you can just add 1 drop LISS following decanting the 4 drops of washed cells.

DMR, that is exacty the information that I got. The concentration of the cells would only be done on a rare ocassion due to a fasle positive due to cold agglutination, or panreactivity with the ortho cells. Warm autoantibody, etc. I defininately would not buy the overpriced ortho 3% cells. So having to revert to concentrating the cells once in 3-4 months would not be a routine process.

I am in the process of implementing the concentration of the cells to 3% as above. Do you need to do validation studies? Does this process get rid of positive reactions caused by antibodies to the preservative/antibiotic/unknown substance that can, but rarely happens with gels.

You are right, L106, is the testing mandatory or just good standard practice. The patient may be either recently transfused or transfused >120days previously. As for the testing of the donor cells, the main hospital keeps segments of the units that we have in our inventory. They pull the segments and test them for the corresponding antigen and enter in the results in a shared computer system, Meditech magic, the units are then transfused. This happens with historic antibodies that are below detection.

I must say that when I came to my facility people would clank the tubes against the convex viewing mirror and then shake the tubes to read the agglutination! Talk about a nightmare. I personnally have found viewing scratchy results microscopically very helpful in AS and ID. But good thing I finally got gel testing into my facility.

Question on subject. If you perform an antibody ID is it required that you actually prove the patient to be antigen negative, or is it ok to just make sure the donor cells are antigen negative and IAT crossmatch compatible. I ask this as we are starting to do antibody identifications using gel after 2 years of not doing ID's. We are part of a 5 hospital system and our large main hospital supplies us our blood. Would it be reasonable to do the ID, not antigen type the patient, and have the main hospital antigen type our units from segments at there facility, perform gel IAT crossmatch of the antigen negative units, and then transfuse. The antigen typing could be done on the patient later by sending cells to the main facility. Thoughts??

I have a question about antibody screens. We use MTS ortho gel 2 cell screen. Should we be using a 3 cell screen so we can get S and s with homozygous expression or is the increased sensitivity good enough to run a heterozygous S and s.

We use gel for both Type and Screens and have had a recent rash of patients with multiple myeloma causing us problems with the gel screens, but not always with the type. So I had everyone start adding plasma to the patient control cells in the screen, to pick up interference due to colds or protein. If the control is positive the screen must be redone using tube. This may help you.