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Blood Bank Automation


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  • 1 month later...

I have not seen any review that compares the 3 instruments.

When we were deciding which instrument to buy, both Ortho and Immucor showed us the instrument in a hospital. I thought it was important to talk to actual users - how automation fits into their workflow, how they did training and validation, what good points and bad points they have found.

We choose the best fit for us - our volume, workflow and staff.

Our needs might not be your needs.

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  • 4 months later...

We are now looking at the Provue and Echo. I am behind the curve on information. Would you please share a brief explanation of which instrument you chose and if possible the pros and cons between the Provue and Echo? Any and all views are welcome.

Thanks

KGoldman

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I, too, would be interested in any and all information regarding the ProVue and Echo. Currently we perform all testing in tube and are looking to automate. So far, I've seen an in hospital demo of the ProVue, and a "road-show" demo of the Echo. The pro's and con's I've noticed so far are (from memory, so I might not be completely accurate here...):

ECHO - faster turn around time (21-26 minutes compared to ProVue's 30+ minutes), tech replaceable probe (ProVue requires a service call for a probe crash), no reagent priming with the ECHO (therefore, minimal reagent wasteage). However, it's brand new to the market and there are no users in our area to use as a reference, etc. Also, the ECHO only offers an IgG crossmatch. If you opted to perform immediate spin crossmatches, you'd need to tube them. (Not an issue if you're computer crossmatching...we're not there yet.)

PROVUE - just over 3 yrs. on the market, several users/resources in our area. We're also interested in making blood bank testing more accessible to techs who aren't "blood bankers." And the gel technology seems the easier way to go, as some tube testing would be involved if the ECHO was down (front types I think...). ProVue offers a 10-min "immediate spin" crossmatch (better than the 20+ for the ECHO's IgG XM, but again, there's no tube testing involved with the ProVue Gel technology.

Just my thoughts....any others??

Heather

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  • 2 months later...

Is anyone aware of a published review that compares the Galileo, Tango and ProVue?

Hi Janet,

I'm also researching automation machines and there are 2 papers that I've heard of that compare Galileo vs. ProVue:

1) UCLA study

2) Nexus, Global Solutions

I don't have a copy, but if you get one, please let me know. Thank you!

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I, too, would be interested in any and all information regarding the ProVue and Echo. Currently we perform all testing in tube and are looking to automate. So far, I've seen an in hospital demo of the ProVue, and a "road-show" demo of the Echo. The pro's and con's I've noticed so far are (from memory, so I might not be completely accurate here...):

ECHO - faster turn around time (21-26 minutes compared to ProVue's 30+ minutes), tech replaceable probe (ProVue requires a service call for a probe crash), no reagent priming with the ECHO (therefore, minimal reagent wasteage). However, it's brand new to the market and there are no users in our area to use as a reference, etc. Also, the ECHO only offers an IgG crossmatch. If you opted to perform immediate spin crossmatches, you'd need to tube them. (Not an issue if you're computer crossmatching...we're not there yet.)

PROVUE - just over 3 yrs. on the market, several users/resources in our area. We're also interested in making blood bank testing more accessible to techs who aren't "blood bankers." And the gel technology seems the easier way to go, as some tube testing would be involved if the ECHO was down (front types I think...). ProVue offers a 10-min "immediate spin" crossmatch (better than the 20+ for the ECHO's IgG XM, but again, there's no tube testing involved with the ProVue Gel technology.

Just my thoughts....any others??

Heather

I'm also researching automation machines and am very interested in learning more about why one would go from manual to automation and which machine to use (esp. the ProVue vs. ECHO debate).

I'm new to the industry and wonder if volume of tests + shortage of MTs = need to automate. Are the manual places feeling the pain that much that they'd get a ProVue or ECHO? or some other machine? Any insight would be much appreciated.

Also, why gel card vs. solid phase? Familiarity or cost or better results? Sorry for all the questions, but I'm researching the industry and would love to hear from the folks in the trenches.

Thanks in advance.

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You can add specimens onto the Provue when it's running, we do it all the time. You do not have to wait until the incubation is done.

One of the reasons we chose gel was because the same reagents are used both automated and manually.

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Yes, you can interrupt both instruments to run a STAT, for example. HOWEVER, it seemed that on the Provue, you cannot physically load the specimen until an instrument-determined time when access to lift the lid is allowed.

On the ECHO, you can load a specimen at your leisure. Neither instrument will begin to process the specimen until it best fits into the workflow. But, as a generalist, I prefer to get the specimen out of my hand over waiting for the instrument to be ready to accept it.

Additionally, with each new specimen added on the Provue, the instrument must RESCAN all reagent barcodes (a pretty timely process if you have reagents and panel cells loaded). Because the ECHO's barcode reader is it's "gatekeeper" AND the specimen vs. reagent areas are separate, there is no reagent barcode re-scan with a new patient specimen on the ECHO.

Heather

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We have been looking at both of these analyzers as well. I am leaning towards the Echo, because of the simpler sample handling.

In addition to needing to wait for loading a STAT on Provue (I think this would drive the night shift nuts!), when you unload specimens, you need to tell it what you have removed. It seems more cumbersome that necessary to me, and not up to par with the Echo.

One reason I would get the Provue is that we currenly use manual gel technology, and the techs are used to it. However, what are Med Techs if not adaptable people who constantly get new technology?

Linda Frederick

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We've been using the Provue since 2003. You can add testing once you have started a run. It will finish what it is currently pipetting, then start on the stat that was just loaded. We went with automation when our workload increased to the point we needed help but not quite a full FTE. By having automation, we can now stay with our current staffing. We chose gel back in 1998 because when we did comparison testing, we found too many false positives with the solid phase. I'm sure there have been many improvements in both methods over the years, but our staff is comfortable with the gel system and the Provue helps us manage our workload.

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I guess I mislead saying you can't add samples to the Provue......we just choose not to I guess because it is so time consuming to wait for it to be 'ready' to accept the sample, then rescan everything and start on the new sample (causing your previous batch to be delayed). Much easier (and definitly faster) to set it up manually!

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We have the Galileo and have had so many false positives we can not use it to run panels. A smaller lab I worked at used the manual Capture-R system and had a high amount of false positives as well as false negatives when compared to Peg panels. We are considering the Provue since our techs are confident with Gel. Any feedback on Provue is greatly appreciated. :D

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  • 2 months later...

I am interested in your report of false positives. Were these antibody screens that had no identifiable antibody with a panel? or screens that were not positive by some other method? We have all encountered method-dependent antibodies as no one method will detect all antibodies in all circumstances. Most times I would rather have a false positive than a false negative, even if it results in extra work missing an antibody could have far more significant sequelae.

jc

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I think "false positive" is a somewhat inaccurate term. Many of our reactive specimens that we are unable to ID an antibody on come back as a clearly identifiable (sp?) antibody later, although we have noticed cross reactivity with anti-cardiolipins (positive VDRLs example). We were the first North American installation of the Galileo and I have years worth of data on the "false positives" - I think a lot of your mileage depends on your patient population.

One item of note, however, it seems Immucors screening cells were more sensitive than their panel cells (why, I dunno...) they have supposedly addressed and corrected that issue (or so the office rumor here goes...)

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  • 4 weeks later...
  • 4 weeks later...

We are in the process of purchasing an Immucor Galileo ECHO.

Currently we use red top serum and tube testing (and will keep that as our backup method). Can anyone offer a recommended validation plan for me? I'm going to also be switching to plasma at the same time as automating. Should I do the serum to plasma validation now to get it out of the way? Or is there a way to consolidate the tube -> capture and serum -> plasma validations?

Thanks!

Heather

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Immucor provides a very thorough validation template for the instrument/methodology. It would not be difficult to expand on that validation to include serum vs plasma studies. You could even use the same comparative method templates that Immucor provides. I created my own spreadsheet in excel, patterned after the Immucor template, that automatically calculates true pos/true neg/false pos/false neg and correlation percentage. I plug my reactions into that, attach the print-outs from the Echo and copies of the manual (reference method) results. If I finish my procedures this weekend I'll be tubeless (well, almost) next week! Hooray!!!

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  • 1 month later...

TANGO question:

For US customers, what back-up method have you implemented? It looks like the UK package inserts (downloaded from the website) for Erytype-S and Solidscreen II-S provide manual instructions, but not for the US...

Is manual tube the back-up? Seems like it would be a lot of waste on the short-dated products. How do you know how much to have on standing order?

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