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Hi guys, I haven't been exposed as a blood banker for quite some time, so please bear with me. Recently, our institution had a case of transfusion reaction (lower back pain) with one unit of PRBCs. The testing details are as follows: History: Non-specific reaction (Multiple encounters) Pre Transfusion Sample Solid Phase : 2 of 3 cels 2+ (Positive Gel Card (Regular) : Negative Gel Card (Enzyme) : Negative Dx: Non-Specific Reaction, all siginificant antibodies excluded Transfusion Reaction Investigation Sample Solid Phase : 2 of 3 cels 2+ (suggestive with Anti-Jka) Gel Card (Regular) : Positive (2+) Minimum grade (Clear-cut Anti-Jka) Gel Card (Enzyme) : Positive (4+) (Clear-cut Anti-Jka) DAT (Gel Card) : Positive Elution Testing: Anti-Jka Detected Dx: Anti-Jka Analyzing the encounter, me and a colleague, through curiosity re-ran the Pre Transfusion Sample: Pre Transfusion Sample: (Curiosity Run) Solid Phase : 2 of 3 cels 2+ (suggestive with Anti-Jka) Gel Card (Regular) : Positive ; Wp Minimum grade (suggestive with Anti-Jka) Gel Card (Enzyme) : Positive ; 1+ Minimum grade (suggestive with Anti-Jka) Taking all details, I could presume that the Gel Card results (both regular and enzyme, which I believe was ran at the same time) of the 1st Pre Transfusion Sample was the jinx. So confidence to the testing method lies to the daily QC of the Gel Card which was ran first thing of the day. Now, I'm asking, if Solid-phase technology could incorporate a positive control and negative control to each strip of testing, why aren't there any on the Gel Card Method? Next, if the Solid-phase technology could also incorporate a "system trap" to ensure the addition of patient's sample to the testing, through it's Capture LISS, why cant the Gel Card do so? I believe that seeing an all-negative resulted panel would be enough for some people for exclusion. Lastly, if reagents aren't available for the Gel card method to ensure the addition of plasma, should our institution enforce a backup procedure that could ensure the reviewer that none of the essential components of the testing (e.g. Patient's plasma) is not missed? Hoping for the masters.. Thanks ! lingkywz