Rh antigen typing on Vision

[RRay]

If you are doing CcEe antigen typing on the Vision, what are you using for QC?

I had been using extra tube panel cells spun down for my controls, but it seems that the cell % has been reduced by the manufacturer to around half and I don't get enough cells after spin down.  Cutting corners maybe??  I'm having to double the amount of tube reagent cells I need to spin down.  I can alternatively use unit segs for R1R1 and R2R2, but with my inventory size I have trouble getting r"r and r'r.  Ortho has only recommended that we use unit segments as they didn't have any other commercial QC to offer.  Vision will only accept centrifuged blood as a control type for this, so no 3% suspension and it can't convert from 0.8% to 3% on board.

Any suggestions? 

[Malcolm Needs ☆]

May I ask if you are talking about positive controls or negative controls?

The reason I ask is that, if you are talking about positive controls, you should not be using R1R1 or R2R2 red cells anyway, as they have homozygous expression of the C and e, and the c and E antigens (unless, of course, they are from a donor with a VERY rare type, such as R1/D-- or R1/Rhnull).  Should you be using unit segments from a presumed R1R2 donor.  On the other hand, if you are talking about negative controls, then even if you did find it easier to get r"r or r'r units, they, of course, would have heterozygous expression of the E and e antigens, and the C and c antigens, and so would be unsuitable for negative controls for those antisera.

I'm sorry if I am sounding like I am trying to "teach my Grandmother to suck eggs" (and it is probably me getting entirely the "wrong end of the stick"), but I am totally confused.

[Bet'naSBB]

We use Immucor's WBcorQC product....it was actually recommended to us by the service rep that installed / trained us on our VisonMax's .......(on the sly since it's an Immucor product) - but they work great!

In the IFU it states the Rh phenotypes of each tube....and the types are consistent from lot to lot so you don't have to re-program your QC with every new lot.

The kit contains 8 tubes (2 each of 4 controls.) good for about a month.

[RRay]

1 hour ago, Bet'naSBB said:

We use Immucor's WBcorQC product....it was actually recommended to us by the service rep that installed / trained us on our VisonMax's .......(on the sly since it's an Immucor product) - but they work great!

In the IFU it states the Rh phenotypes of each tube....and the types are consistent from lot to lot so you don't have to re-program your QC with every new lot.

The kit contains 8 tubes (2 each of 4 controls.) good for about a month.

Fabulous! Thank you!

[RRay]

21 hours ago, Malcolm Needs said:

May I ask if you are talking about positive controls or negative controls?

The reason I ask is that, if you are talking about positive controls, you should not be using R1R1 or R2R2 red cells anyway, as they have homozygous expression of the C and e, and the c and E antigens (unless, of course, they are from a donor with a VERY rare type, such as R1/D-- or R1/Rhnull).  Should you be using unit segments from a presumed R1R2 donor.  On the other hand, if you are talking about negative controls, then even if you did find it easier to get r"r or r'r units, they, of course, would have heterozygous expression of the E and e antigens, and the C and c antigens, and so would be unsuitable for negative controls for those antisera.

I'm sorry if I am sounding like I am trying to "teach my Grandmother to suck eggs" (and it is probably me getting entirely the "wrong end of the stick"), but I am totally confused.

I don't understand the problem.  We use the R1R1, R2R2, r'r, r"r set simply because those are most readily available/abundant from our reagent red cell sets.

C: positive control- r'r  , negative control- R2R2

c: positive control- r'r   , negative control- R1R1

E: positive control- r"r   , negative control- R1R1

e: positive control- r"r  , negative control-R2R2

I know there are other options more readily available within the general population, and likely our inventory too... but then there's a conundrum.  How do you test units you hope to use for controls without the method being QC'd in the first place?  It's a tight cycle to upkeep for a small group of generalists.  We don't have full antigen information disclosed from our blood supplier either.

Personally, I can use my own blood for several of the controls... but I don't want an extra monthly poke! Haha!

[Malcolm Needs ☆]

Thanks.  Now I can see from where you are coming, and that all makes it plain, and I was being stupid!

The problem is, in the UK, every unit has the Rh phenotype on the bag label (see the attached photograph), and I keep forgetting that is not the same in all countries (I am being parochial in my old age!).

[RRay]

7 minutes ago, Malcolm Needs said:

Thanks.  Now I can see from where you are coming, and that all makes it plain, and I was being stupid!

The problem is, in the UK, every unit has the Rh phenotype on the bag label (see the attached photograph), and I keep forgetting that is not the same in all countries (I am being parochial in my old age!).

 

That would be nice.  Blood centers here want to charge us for that.  They may keep it on file, but won't provide the info unless you pay... especially lookin' at you Red Cross!

[MAGNUM]

Hey Malcolm, I especially like the bottom right quadrant that says "Date Bled".  We really need the phenotypes included on the unit face label.

 

[jayinsat]

On 7/27/2023 at 7:53 AM, Bet'naSBB said:

We use Immucor's WBcorQC product....it was actually recommended to us by the service rep that installed / trained us on our VisonMax's .......(on the sly since it's an Immucor product) - but they work great!

In the IFU it states the Rh phenotypes of each tube....and the types are consistent from lot to lot so you don't have to re-program your QC with every new lot.

The kit contains 8 tubes (2 each of 4 controls.) good for about a month.

Wow. Ortho does not produce their own qc material for antigen typing? We use the ECHO Lumena and the WBcorQC make that such a simple process.  I'm surprised Ortho does not make their own.

Now, if we can just get CAP to produce their RBCAT proficiency testing vials so we can run them on the ECHO's. That would be great!

Edited July 31, 2023 by jayinsat

[AMcCord]

On 7/31/2023 at 8:49 AM, jayinsat said:

Now, if we can just get CAP to produce their RBCAT proficiency testing vials so we can run them on the ECHO's. That would be great!

Bet they will sooner than later as more antigen typing is automated. I was delighted when the DAT survey for automation came out, even if it is ungraded for now.

[jayinsat]

On 8/3/2023 at 9:27 AM, AMcCord said:

Bet they will sooner than later as more antigen typing is automated. I was delighted when the DAT survey for automation came out, even if it is ungraded for now.

Same. Are you doing both DAT Automation and DAT manual survey's? 

[AMcCord]

23 hours ago, jayinsat said:

Same. Are you doing both DAT Automation and DAT manual survey's? 

We are doing both. We use automation at this time only for cord blood specimens, but having a survey will save us from the alternative testing issue on the All Common CAP checklist.

[applejw]

We use both the CAP DAT and API Automated DAT surveys to cover automated, manual gel and tube testing.   The API surveys are graded.