Antibody ID methodology

[RR1]

More laboratories are using solid phase techniques for antibody screening. When an antibody is detected by a solid phase panel- and specificity cannot be identified, would labs normally refer these to reference labs, and if so..what techniques would the reference labs use to identify the antibody?

My current practice is to perform a second panel by Gel. However the manufacturers claim we may be missing Anti-Jka, anti-Jb antibodies.

What is the 'gold standard' technique for antibody identification ?

Thanks!

[Malcolm Needs ☆]

As a Reference Laboratory (actually, your Reference Laboratory, Rashmi) we use the DiaMed gel technique as our first "line of defence", but if we do not detect anything by this technique, we will go on to perform LISS tube IAT at 37oC. We consider this latter technique to be the "gold standard", and if we do not detect anything by this technique, we look no further (on the grounds that, if we don't detect an antibody by this technique, even if there is one present, it is unlkely to be clinically significant.

Just occasionally, we will perform a LISS tube direct agglutination at 15oC, if we think that the referring laboratory may have detected a "cold reacting" antibody with a true specificity, such as anti-M, but only if it's a slow day and we are bored!

[RR1]

Thank you Malcolm,

Do you find many antibodies by tube but that are not detected by Diamed Gel?

[Malcolm Needs ☆]

Not an enormous number by any means, but I would say that we do find the about four or five a year.

[RR1]

Would it be a good project to refer these ones to a ref lab that uses solid phase ?

[Malcolm Needs ☆]

Could do. We could also send those samples from solid phase users in which we find nothing to NHSBT-Birmingham Centre, who have solid phase available to them.

I'm sure Paul Fleetwood and Ian Skidmore at Birmingham would be immensely pleased!!!!!!!!!!!!!!!!!!!!!!!!!!

[RR1]

Excellent idea ! ...it would be for a very worthy cause...and help everyone develop a better understanding of the different techniques being used and their limitations/ good points.

When are going to start this?!!

[Malcolm Needs ☆]

I'm off with a bad back at the moment, but will talk to Paul/Ian as soon as I can crawl back in.

I suppose I should talk to Gordon Burgess, my Line Manager too.

[irshadaad]

This is a nice piece i ll try it thanks for valuable advices,