JHDM 0 Posted January 23 We recently had a positive antibody screen in gel, we ran a panel ( also in gel) and got some reactions but no pattern and everything was ruled out. We then did an antibody screen in tube and saw that there was rouleaux at immediate spin but the screen was negative at AHG. Is it common to have rouleaux interference in gel? Also, there was some disagreement among techs on whether we should do an immediate spin crossmatch only or an AHG crossmatch in these situations. I would appreciate any input Share this post Link to post Share on other sites
yan xia 193 Posted January 23 We use Ortho Biovue gel card, and I don't think rouleaux interfere much on the gel result, some MM patients have rouleux on tube, but gel results are good. In my experience, cold antibodies can do. Just personal opinion. 2 Malcolm Needs and Ensis01 reacted to this Share this post Link to post Share on other sites
StevenB 118 Posted January 23 14 hours ago, JHDM said: We recently had a positive antibody screen in gel, we ran a panel ( also in gel) and got some reactions but no pattern and everything was ruled out. We then did an antibody screen in tube and saw that there was rouleaux at immediate spin but the screen was negative at AHG. Is it common to have rouleaux interference in gel? Also, there was some disagreement among techs on whether we should do an immediate spin crossmatch only or an AHG crossmatch in these situations. I would appreciate any input It's not uncommon to see rouleaux interference in Gel testing but it's not something we see frequently. The crossmatch question is interesting: Technically, the screen is negative for alloantibody reactivity so I think you'd be able to follow your procedure for that result. However, with the immediate spin crossmatch, you may have to perform a saline replacement to obtain a "compatible" unit. I wouldn't want to assume an incompatible IS crossmatch is due to the rouleaux without confirming that. 4 yan xia, Malcolm Needs, Ensis01 and 1 other reacted to this Share this post Link to post Share on other sites
Ensis01 107 Posted January 24 My experience is that interference from rouleaux and cold autoantibodies in Gel is not unusual but this may depend on your patient population. As rouleaux is not an antibody an AHG crossmatch is not required. If you IS crossmatch you must (in my opinion) saline replace so you show any agglutination is interference and can therefore enter a negative/compatible/non-reactive result into your LISS, probably with a comment. 5 Malcolm Needs, AMcCord, David Saikin and 2 others reacted to this Share this post Link to post Share on other sites
Ally 4 Posted January 28 Yes, Rouleaux interference is common in gel testing. Make sure to follow what's recommended for time and speed when you spin your specimen. if you have negative results on IgG phase I do agree with Ensis do saline replacement if it's negative resulted as such and add a comment. 1 Ensis01 reacted to this Share this post Link to post Share on other sites
