exlimey

Where are the lights ?

Along the same lines......the basis of my personal safety approach: "If it's wet, and NOT yours, don't touch it."

My two cents: One CALENDAR month........If you open something on the 15th, it expires on the 15th of the next month, regardless of how many days are in the current month. But...... you have to be careful to not open something on the 29th, 30th or 31st of January..., or the 31st if the next month has 30 days....

I'm sure there are lots of variations between both Complement content of sera and the number "binding sites" on red cells. I suspect others on this site can provide references. This is assuming you are using the same antiglobulin reagent each time: To even out the variations, I suggest you use a pool of Complement sources (3 - 5). You may also consider using a similar pool of red cells. This may help lot-to-lot consistency. Ideally, in a perfectly-controlled world, one should use the same Complement source(s)and red cell source(s) each time you prepare a batch.

Interesting. I like the "no one else is having a problem" line - the implication being that the problem is a result of something done by the end user. Random contamination (darkening) seems to be the bane of red cell manufacturers. Often, the randomness is exactly as you describe: one vial bad, another of the same batch is fine. It's very difficult to pin down a cause - could be their storage solution, could be inadequate sterilization of the containers/droppers, could be shipping, etc. I doubt there will be any resolution. I would send them pictures and ask for replacements.

Is the supplier of the affected panels the same as your source for Red Cell Storage Solution (Alsevers)?

An EXCELLENT question Darren ! I look forward to some interesting debate.

I agree with Malcolm - the IgG/IgM nature of the antibody is not relevant, and I would avoid tests with enzyme-treated cells in patients with confirmed WAIHA, especially after adsorption procedures. I know that some workers also avoid PEG when testing adsorbed serum in these cases, opting instead for LISS or even saline antiglobulin tests on the adsorbed serum.

Short (facetious) answer: $$$$$$$$$ Long answer - my opinion - Facilities required or choose to follow AABB Standards (and therefore get an inspection) are required to pay for/buy said standards. At the very least, they are "institutional members" that pay an annual membership fee. The AABB Standards are very different from the Technical Manual (in which the universal, public domain procedures reside). I may be wrong, but I think the standards get some kind of tacit approval by the FDA, whereas the TM gets peer-review. Of course, both documents/books are available to anyone for a fee......

Thank you, Johnv. I know the science.

Isn't it fascinating that we're "allowed" to deliberately use a less-sensitive assay when "we" feel it appropriate? Offhand, I can't think of anything similar in other path disciplines. Anyone ? Anyone ? And..... go........

My interpretation: Users of POLYSPECIFIC antiglobulin reagents are obliged to verify performance each day of use, i.e., QC should involve use of IgG-coated cells AND Complement-coated cells. This gives the user confidence that the reagent is performing as expected. During routine testing, addition of IgG-coated cells to negative tests is sufficient to verify that the IAT was performed correctly - correct/effective washing, the antiglobulin reagent was added and is reactive, etc. If it were a requirement to add IgG-coated cells and complement-coated cells to every negative IAT using polyspecific antiglobulin, it would be necessary to run everything in duplicate - one set would get IgG-coated cells and the other set would get complement-coated cells. I don't think that is the case.

PEG-IAT is arguably the most sensitive tube test currently in widespread use. For this reason you're more likely to see concurrence with your Echo/Neo results if you use PEG for supplementary testing, i.e., the sensitivity of the two assays are perhaps the closest (LISS being less-sensitive). However, there's still a chance that the Echo/Neo will detect something that is not detected in PEG (or LISS). I wonder what Immucor would say if you decided to use another manufacturer's PEG reagent ?

I think the term "Chav" has recently become popular. Even more recently, calling someone "a right old Neymar" is not very flattering. As the Irish writer George Bernard Shaw once said: "England and America are two countries divided by a common language."

Wow. Thank you for that information. That certainly could influence the concern some of the medics demonstrate. Is the surgical room also chilled ?