Problems with cell#2 ortho screen cells?

[Brenda K Hutson]

Our goal has been to find out the source of the reactitiviy. If the cell is double dose for the Jka antigen ...we have found in some cases anti-Jka. If the cell is P1s we have identified anti-P1, if the cell is double for the M antigen we have iin some cases identified anti=M, in some we have identified anti-E using ficin gel technique, in the rest we have identified anti=Bg. There is almost always a reason for the reactivity, rarely do we find non specificity. It takes extra effort but in the long run it pays off.

I always approach every work-up that way anyway (see thread on GEL and Jka). I have not seen any patterns with these positive reactions, even with extensive investigation.

Brenda Hutson, CLS(ASCP)SBB

[PammyDQ]

Has anyone else had problems with Ortho screen cells and cell #2 coming up pos when there isn't anything there? I cannot tell you how many of my techs want to call a presumptive anti-E! They can't prove it when we go to the panel but with ortho admitting to problems with E on panels in the past, it makes people over call? Any thoughts?:mad:

Last week I worked up a patient with a known Anti-E by Ortho gel with screen cell lot# VSS245. Cell #2 (E+e-) was a good 1+, but it was non reactive on the panel.......E's are fickle with the gel system. I also worked up a patient with a known Anti-Jka whose reactivity varied between 0 and 3+ on (Jka+Jkb-) cells. I think I understand the WHY of it...just was my first experience in memory with such variation in strength!

[khabeeb]

"We have had less of these types of reactions since we started keeping our 0.8% cells in black boxes that Ortho provided for us (they look like plastic recipe boxes - in fact we got one at a discount store that was a little bigger to keep a panel in)."

Just curious about this black box - is this Ortho's remedy for the spurious results? I have never heard of this.

[Brenda K Hutson]

Last week I worked up a patient with a known Anti-E by Ortho gel with screen cell lot# VSS245. Cell #2 (E+e-) was a good 1+, but it was non reactive on the panel.......E's are fickle with the gel system. I also worked up a patient with a known Anti-Jka whose reactivity varied between 0 and 3+ on (Jka+Jkb-) cells. I think I understand the WHY of it...just was my first experience in memory with such variation in strength!

Just curious since you mentioned Anti-E and GEL. I have seen multiple examples of an Anti-E that reacts with the Surgiscreen II Cell, and reacts with the E+ cells on Ortho Panel A, but is hit and miss with the 3 R2R2 cells always present on the Ortho B Panel. I have really seen it too much to be a coincidence; even to the point that if we get it on Surgiscreen and Panel A, but no all R2R2 cells on Panel B, I will still go after it as an Anti-E.

Brenda Hutson, CLS(ASCP)SBB

[Brenda K Hutson]

"We have had less of these types of reactions since we started keeping our 0.8% cells in black boxes that Ortho provided for us (they look like plastic recipe boxes - in fact we got one at a discount store that was a little bigger to keep a panel in)."

Just curious about this black box - is this Ortho's remedy for the spurious results? I have never heard of this.

When I called Ortho some time ago due to problems with the Screening Cells, they told me of the new formulation and the reactivity with light (I see that was mentioned in other responses to that thread). So, I think that is why they have come up with these black boxes (which I was not offered when I called, but perhaps they had not yet devised them). For a short time after calling them, we would just cut the top off of the Surgiscreen boxes, and place them over the bottles of Screening Cells on the racks, trying to see if it made a difference. It did not seem to; at least for the short time we tried it. Might be worth trying again.

All of that being said, I would still think it should default to Ortho to correct the problem with their new changes to the reagents.

Brenda Hutson,CLS(ASCP)SBB

[Guest jabattani]

We are using VSS249 and are experiencing reactivity with cell 2. On the last lot of panel A we were having problems with cell 7. It is very frustrating, time consuming and expensive.

[bbbirder]

Before we got our Echo, we used manual gel and we were chasing weak reactions that never showed up or matched any thing in gel or tube peg panels.

We got better luck with making up our own fresh diluted cells, so stopped using Ortho's cells completely.

Manual gel is still our back-up.

Linda Frederick

[jbeauvais]

We had a problem with Ortho Cell#2 in lot VS286 the first day it was put into use. A 4+ reaction with it. The tech pulled some cells with low incidence antigens (from another manufacturer) and identified it as Mg. The patient's serum reacted with 2 other examples of Mg+ cells.

Jeanne