Brenda K Hutson Posted August 24, 2009 Share Posted August 24, 2009 Am updating some procedures and want some input. In looking at a Control for Anti-C3b, -3d, it states: A positive control of anti-complement activity is a test with red cells sensitized with complement (low ionic strength or low ionic strength plus trypsin treatment method). Hmmm..seems like at past facilities, we just add Complement Control Cells to Anti-C3b, -3d as a control. Ok, so I am probably humiliating myself by asking this, but what do you all use to QC this reagent?Thanks,Brenda Hutson, CLS(ASCP)SBB Link to comment Share on other sites More sharing options...
swede Posted August 24, 2009 Share Posted August 24, 2009 I'll be humiliated right along with you....we use complement control cells! Link to comment Share on other sites More sharing options...
JOANBALONE Posted August 24, 2009 Share Posted August 24, 2009 Is this a trick question? We use complement control cells too.JB Link to comment Share on other sites More sharing options...
David Saikin Posted August 24, 2009 Share Posted August 24, 2009 Commercial Complement control cells too. Making C activated cells is too spurious and they are notoriously unstable. Link to comment Share on other sites More sharing options...
Brenda K Hutson Posted August 25, 2009 Author Share Posted August 25, 2009 Is this a trick question? We use complement control cells too.JBNo, not a trick question. That is an exact quote from the Manufacturer's Insert.Brenda Hutson, CLS(ASCP)SBB Link to comment Share on other sites More sharing options...
Shari Posted August 25, 2009 Share Posted August 25, 2009 We, too, use Complement Control Cells Link to comment Share on other sites More sharing options...
Eagle Eye Posted August 26, 2009 Share Posted August 26, 2009 We use complement control cells. Link to comment Share on other sites More sharing options...
phouck Posted August 26, 2009 Share Posted August 26, 2009 We use complement control cells, too. Link to comment Share on other sites More sharing options...
SMW Posted August 27, 2009 Share Posted August 27, 2009 .....: A positive control of anti-complement activity is a test with red cells sensitized with complement (low ionic strength or low ionic strength plus trypsin treatment method). ....Aren't the reagent complement control cells "red cells sensitized with complement"? Perhaps the manufacturer of the anti-complement reagent you're using does not produce/distribute reagent complement control cells so is being somewhat vague to not appear to be referring you to use another company's product? Link to comment Share on other sites More sharing options...
Mary** Posted August 27, 2009 Share Posted August 27, 2009 Immucor does not recommend the use of their complement control cells with another manufacturer's anti-C3B,C3d. Link to comment Share on other sites More sharing options...
pmata Posted August 27, 2009 Share Posted August 27, 2009 Thank you, Mary... this explains why they often do not work with the Ortho reagent. Link to comment Share on other sites More sharing options...
David Saikin Posted August 29, 2009 Share Posted August 29, 2009 They often do not work (in tubes) with the Immucor reagent too. 4+ in buffered gel with anti-C3b,-C3d, even after 5' incubation. Link to comment Share on other sites More sharing options...
Brenda K Hutson Posted August 30, 2009 Author Share Posted August 30, 2009 Right, I know this has been an ongoing problem. When I was a Supervisor at a Reference Lab, I put on 2 Seminars a year, inviting various Blood Bank speakers from all over. There were 6-1 hr. sessions and the last 1 hour, I called "Ask the Experts." It was a questoin and answer forum with myself, and the head of the other 2 local Reference Labs. At one of these meetings, I recall someone bringing up this very issue, and you could hear agreement throughout the room (and we are talkng over 200 people). We did mention the fact that they should be incubated at RT for 5', but as you said, even that sometimes does not work.But here is why we have 2 Manufacturer's: in looking into this more (since these orders have been in place long before I came), it appears that Ortho does not have a Complement Control Cell (and we do use their Anti-C3b, 3d) and the Anti-C3b, 3d by Immucor, would cost us MUCH more than what we are purchasing from Ortho. So that is a dilemna. I am thinking it is odd that Ortho would sell the antisera but not the control cells. I do use Gel, but only for Antibody Screen, Antibody ID; we do not purchase any of the other cards. Someone in this Thread mentioned using the cards for C' testing. I think I need to investigate that before I put out a lot of $$ for Immucor Anti-C3b, 3d.Brenda Link to comment Share on other sites More sharing options...
AMcCord Posted September 3, 2009 Share Posted September 3, 2009 Complement Control Cells are 'designed' to react 1-2+ according to the insert, so they aren't going to be really strong reactors. I find that your shaking technique can make a huge difference in what your reaction strengths are with these cells. When I have a tech who consistently gets a 1+ at best (or less), I watch their technique and often they are pretty enthusiastic shakers. I have them ease up and they usually get better results. I also use Comp Control Cells to educate students about shaking out tubes properly. If the control cells are really fresh, I can almost always get a 2+, sometimes a 3+ (unless the cells were shipped on a HOT summer day - takes the stuffing right out of them!). I tend to open the new lot when it comes in, rather than waiting for the previous lot to outdate before switching lots. I think that helps quite a bit, too. I do incubate patient tubes for 5 minutes with anti-C3 prior to reading, but I don't incubate for 5 minutes with the control cells. Link to comment Share on other sites More sharing options...
Malcolm Needs ☆ Posted September 3, 2009 Share Posted September 3, 2009 Complement Control Cells are 'designed' to react 1-2+ according to the insert, so they aren't going to be really strong reactors. I find that your shaking technique can make a huge difference in what your reaction strengths are with these cells. When I have a tech who consistently gets a 1+ at best (or less), I watch their technique and often they are pretty enthusiastic shakers. I have them ease up and they usually get better results. I also use Comp Control Cells to educate students about shaking out tubes properly. If the control cells are really fresh, I can almost always get a 2+, sometimes a 3+ (unless the cells were shipped on a HOT summer day - takes the stuffing right out of them!). I tend to open the new lot when it comes in, rather than waiting for the previous lot to outdate before switching lots. I think that helps quite a bit, too. I do incubate patient tubes for 5 minutes with anti-C3 prior to reading, but I don't incubate for 5 minutes with the control cells.I'm sorry; I know I'm a pain, but I am a little worried about the word "shaking" (although I do know what you mean). There are so many people nowadays who are very "anti-tube" that I would prefer the term "gentle resuspension by a slight rolling motion of the tubes".There; that's got that off my over-pedantic chest!!!!!!!!!!!!!!:redface::redface: Link to comment Share on other sites More sharing options...
AMcCord Posted September 3, 2009 Share Posted September 3, 2009 I do agree with you Malcolm, "shaking" is the problem. I was taught to tip, observe for sheeting, tremble with your dainty fingertips, repeat the tip.... The first thing I do with a new tech or a student in Blood Bank for their clinicals is to correct their bad "shaking' habits. Most of them arrive with a lot of wrist action. It's also amazing how many of my long term Blood Bankers pick up that bad habit over time. Link to comment Share on other sites More sharing options...
Malcolm Needs ☆ Posted September 3, 2009 Share Posted September 3, 2009 I do agree with you Malcolm, "shaking" is the problem. I was taught to tip, observe for sheeting, tremble with your dainty fingertips, repeat the tip.... The first thing I do with a new tech or a student in Blood Bank for their clinicals is to correct their bad "shaking' habits. Most of them arrive with a lot of wrist action. It's also amazing how many of my long term Blood Bankers pick up that bad habit over time.Oh phew! I thought that you could take offence (although it was not meant in any way like that)!Thanks.Now, about my dainty fingertips. Imagine four salamis, touched off with a log, and you've got my fingers and thumbs.....:disbelief:disbelief:disbelief Link to comment Share on other sites More sharing options...
Brenda K Hutson Posted September 4, 2009 Author Share Posted September 4, 2009 Complement Control Cells are 'designed' to react 1-2+ according to the insert, so they aren't going to be really strong reactors. I find that your shaking technique can make a huge difference in what your reaction strengths are with these cells. When I have a tech who consistently gets a 1+ at best (or less), I watch their technique and often they are pretty enthusiastic shakers. I have them ease up and they usually get better results. I also use Comp Control Cells to educate students about shaking out tubes properly. If the control cells are really fresh, I can almost always get a 2+, sometimes a 3+ (unless the cells were shipped on a HOT summer day - takes the stuffing right out of them!). I tend to open the new lot when it comes in, rather than waiting for the previous lot to outdate before switching lots. I think that helps quite a bit, too. I do incubate patient tubes for 5 minutes with anti-C3 prior to reading, but I don't incubate for 5 minutes with the control cells.Well, if you are able to get > 2+ reactions with your complement control cells, without a 5' incubation, you are doing better than most Hospitals. If I am correct, the Manufacturer's Insert also refers to incubating for 5'. Even then, it can be troublsome (and I think I have the hang of resuspending cells at this stage of the game). Brenda Hutson, MT(ASCP)SBB Link to comment Share on other sites More sharing options...
David Saikin Posted September 4, 2009 Share Posted September 4, 2009 Oh man, I was always taught to resuspend tubes like I had the "DTs". It was an axiom where I trained (decades ago) that if you could shake it off, it isn't there. The only tubes we resuspended gently were cord DATs. Link to comment Share on other sites More sharing options...
eric1980 Posted September 8, 2009 Share Posted September 8, 2009 My lab makes complement-coated cells for controls... Link to comment Share on other sites More sharing options...
jeloweryii Posted September 9, 2009 Share Posted September 9, 2009 As David Saikin stated, "Making C activated cells is too spurious and they are notoriously unstable. " For those of you who are making your own C3 control cells successfully, I am curious as to which methods are being used. Link to comment Share on other sites More sharing options...
AMcCord Posted September 11, 2009 Share Posted September 11, 2009 Well, if you are able to get > 2+ reactions with your complement control cells, without a 5' incubation, you are doing better than most Hospitals. If I am correct, the Manufacturer's Insert also refers to incubating for 5'. Even then, it can be troublsome (and I think I have the hang of resuspending cells at this stage of the game).Brenda Hutson, MT(ASCP)SBBI don't incubate for 5' for QC of the reagent. If I can't get a good reaction with QC straigt up, then I would consider my reagent to have a problem (deterioration, contamination, whatever), though that hasn't happened so far...knock on wood. All patient tests (and my negative reagent control) get the 5' incubation. Link to comment Share on other sites More sharing options...
SMW Posted September 11, 2009 Share Posted September 11, 2009 I don't understand the rationale of not following the manufacturer's instructions when performing the quality control testing . If the manufactuer says to add 2 drops of a reagent to the test system, do you only add 1 drop to your control test? If the manufacturer states to incubate your Hepatitis B surface antigen assay for 3 hours, do you only incubate your controls for 30 minutes and if they work then the patient assays at 3 hours must be OK? It's one thing to select a control that will detect/express a weak antigen (single dose expression vs. double dose) or be capable of detecting a low level of antibody when following the manufacturer's instructions. It's a whole other animal to decide to test your controls in a different manner than your test samples. Since you are not challenging the actual testing process, how can you interpret the control results as valid? Link to comment Share on other sites More sharing options...
eric1980 Posted September 21, 2009 Share Posted September 21, 2009 The recipe for the C'-coated cells we use in my lab is as follows:-Make 10% sucrose solution.-Extort a tube of blood from a O RH(D) POS colleague.-Mix 5ml of sucrose solution with 5 drops of packed donor RBC and 20 drops of donor serum.-Incubate 15mins@37C.-Wash with saline and then lastly resuspend with a preservative to ~3% HCT. (We use DiaMed CellStab)-Controls are anti-IgG and anti-C'.The C'-coated cells should not react with anti-IgG but should react well with the anti-C'. The shelf-life should end when there is haemolysis or after a week, whichever comes first. Link to comment Share on other sites More sharing options...
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