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Ortho Vision Gel


bman2k
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We just started using the new Ortho Vision coming from manual tube method. We saw an increase of Anti-D positive (negative patient history) as the gel are more sensitive. We repeat the test with the now back-up tube method (negative result) and just report as negative for the anti-D.

My question is, what is your blood bank policy in handling these discrepant result between the gel and the tube method?  Do you just report as negative or do you change it to positive? 

Thank you.

Edited by bman2k
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  • bman2k changed the title to Ortho Vision Gel

We do not do the testing in tube to confirm. We will send the sample to American Red Cross for Genotyping for RHD variants if the reaction is 1-2+. The majority come back as weak D type 1 and are not considered to be at risk for production of allo-anti-D. It is generally accepted that females of child-bearing potential with weak D type 1 can be considered D positive for transfusion and are not candidates for Rh immune globulin. Their type will be updated with that comment. If the patient comes back as one of the other weak D types and there is a chance for production of the allo-anti-D, we will leave it as Rh negative and put the comment that testing was done in the patient history.

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We do similar to labguru.  We went from manual tube to automated gel (BioRad) and have found the same thing.  If we have a discrepancy we send it out for genotyping.  Most come back as a weak D type 1 (or 2 or 3). 

I am considering doing a manual tube type on our females less than 45 when they type as Rh positive the first time.  And then sending out any discrepancies for genotyping.

sandra

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For gel 2+ or less, we ask provider to allow us to send out for molecular typing if patient has childbearing potential.  Otherwise, we usually interpret them as D positive but add a note that their type is weak and atypical so they may sometimes be reported as negative and other times (other places) as positive.   If they have anti-D or some other reason (anti-C & anti-E?) we will choose to call them D neg.

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