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No Reactivity with Complement Control Cells


Mary**

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We are not getting any reactivity with our Complement Control Cells. They don't expire for another 11 days. We tried 2 different lot numbers of anti-sera and got the same results. We had this same problem about a year ago. Both the anti-C3b, C3d and the check cells are the same brand. Is anyone else experiencing this? It will probably take the maufacturer a year to "recall" them.:bonk:

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I have noticed that when performing anti-Compl testing using tubes, the Immucor control cells react notoriously weak; even after 5 minute incubation I would be lucky to get a really good 1+ reaction. Now I do this testing using Ortho's buffered gel card. The Immucor cells are always 3-4+ with this test system (when used neat or as 0.8%).

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We noticed that when using the Immucor complement cells with the Ortho anti-C3d, the results were non-existent even after 5-10 minutes incubation at room temperature. At first I thought the problem was with the complement cells, but after ordering Immucor anti-C3d, we noticed the reactions were stronger. After evaluating the Ortho and Immucor anti-C3d we decided to use the Immucor product. I also noticed that the Ortho product was anti-C3d, while the Immucor antisera was a combination of anti-C3d,C3b. Ortho offers an anti-C3d,C3b product, but I never evaluated this product. I figured; why not use Immucor antisera and controlling it with Immucor C3d control

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The package insert for the Immucor complement control cells states that "agglutination by anti-complement is seldom as strong as that customarily seen with anti-IgG and is more readily dispersed". Our expected QC result for anti-complement QC is W+-1+. I like this control because it also QCs the techs ability to not "over-shake" in tube testing, and ability to detect weakly reactive agglutination.

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Complement Control Cells can also be adversely affected by shipping conditions. Once every couple of years I have a lot # that does not work because they came in when the temperatures were 100 F + . Reactions are extremely weak to non-existent. In the winter time, they have come in too cold, showing traces of hemolysis. Those cells need replaced as well.

I agree with the previous poster. The maximum agglutination you should expect is 2+ with 1+ reactions quite normal. The agglutination is fragile. I, too, find them to be a good test of the shaking abilitiy of my techs and students.

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Mary - I have validated my complement testing using Ortho anti-C3b,-C3d. 50 uL of 0.8% cell suspensions of patient cells and Complement Control cells - using the buffered gel card. 25 uL of the anti-C rgnt to both pt cells and Control cells. I also run a neg control of pt cells and diluent - just to be certain I am not seeing something non-specific to complement activity. Incubate for 5 minutes at room temp. 10 minute spin. Someone mentioned to me in a previous thread that they found the gel did not detect weak reacting anti-C activity. My feelings are that if it is that weak, I would not detect it using classic tube technique anyway, so . . . Hope this is helpful.

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Ah, the old shakedown problem. I visited my BB mentor one day. He was working on a transfusion reaction workup. I asked him if it was the usual febrile reaction. He said no, it was a real antibody. It seems that the patient had a 1+ reactivity, but the tech that did the type and screen had a 2+ shakedown. No joke.

BC

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