cassiepenn Posted December 29, 2009 Share Posted December 29, 2009 Quick question about the CLIA regulation. We use gel for out antibody screens and crossmatchs. CLIA is saying that if you are using gel for crossmatching then you wil not detect ABO incombatibility. I am wondering how othe labs are handling this. You can do an immediate spin crossmatch in the ABO gel card. We do not currently do ABO gel we do tube method. I am tring to find out if it would be better just to go to immediate spin crossmathing and if all is negative then stop there. Or do I go to doing ABO and immediate spin crossmatching on gel and do the IGG crossmatch. What are others ****?Thanks,Cassie Link to comment Share on other sites More sharing options...
LaraT23 Posted December 29, 2009 Share Posted December 29, 2009 We do immediate spin only for all patients who have a negative history and negative current antibody screen. For full crossmatches when necessary, we do an immediate spin and then a gel crossmatch. I know what you mean about the gel stuff, but the beads are coated with IgG only so maybe that is the deal with the ABO incompatibility. I myself have seen that ABO incompatible shows up in gel. Link to comment Share on other sites More sharing options...
cassiepenn Posted December 29, 2009 Author Share Posted December 29, 2009 How do you do your antibody screens gel or tube? Link to comment Share on other sites More sharing options...
David Saikin Posted December 30, 2009 Share Posted December 30, 2009 You can validate that your gel xm will detect ABO incompatiblity . . . Link to comment Share on other sites More sharing options...
LaraT23 Posted December 30, 2009 Share Posted December 30, 2009 Too True David. I may actually think of doing that. Hm, I am thinking that 30 samples should do for statistical validity and same number of pos versus neg and you should hit every blood type as well. What do you think? Link to comment Share on other sites More sharing options...
BankerGirl Posted December 31, 2009 Share Posted December 31, 2009 I don't understand CLIA's reasoning on this issue. Why wouldn't the gel pick up an ABO incompatibility? You are still mixing the patient's plasma with the unit cells, and regardless of the IgG, there would be a reaction if there was an ABO incompatibliity. This would still cause the cell complexes to remain on top of the gel, regardless of what was IN the gel. :confused:That being said, validation may still be the way to go. Link to comment Share on other sites More sharing options...
LaraT23 Posted December 31, 2009 Share Posted December 31, 2009 You know I was just curious and did a quick little O patient and A cell and it is a nice 4+ in gel. So, I am going to validate to day because I have a trainee in here to help! Ha Ha no more Immediate spin. Link to comment Share on other sites More sharing options...
LaraT23 Posted December 31, 2009 Share Posted December 31, 2009 Also what reg is this? Do you have the part and number? I need to reference this when I turn in my validation report. Link to comment Share on other sites More sharing options...
mhc Posted December 31, 2009 Share Posted December 31, 2009 You know I was just curious and did a quick little O patient and A cell and it is a nice 4+ in gel. So, I am going to validate to day because I have a trainee in here to help! Ha Ha no more Immediate spin.I found this manuscript that might help with your validation protocol. as you can see, no method is perfect at detecting all ABO incompatibilities, but you should be cautious about using O plasma vs A1 cells and "proving" that the gel method is suitable for detecting ABO incompatibilities.We still require an IS in addition to the IgG gel when doing an AHG XM.abo_geltestjudd.doc Link to comment Share on other sites More sharing options...
LaraT23 Posted December 31, 2009 Share Posted December 31, 2009 Well to be honest this is one of my "hoofbeats" and "zebras" things. How many times to you really think that we will encounter a crossmatch between a B individual and A2B cells? Not often. I myself have A2 cells, so if I want to test with those I can very readily, though I don't anticipate issues. Link to comment Share on other sites More sharing options...
mhc Posted December 31, 2009 Share Posted December 31, 2009 I agree that would be a rare event, but I'm sure you get the point of that study. You need to simulate the "extremes", or limits of detection, when you validate a procedure. That's what gives you the evidence to conclude that your method is as good as, better than or worse than your "gold standard". Link to comment Share on other sites More sharing options...
Malcolm Needs ☆ Posted December 31, 2009 Share Posted December 31, 2009 I usually agree with what you say Lara, but over this one, I'm afraid that I must go with the post from mhc.:redface: Link to comment Share on other sites More sharing options...
Eagle Eye Posted January 2, 2010 Share Posted January 2, 2010 Most of the computer system should flag for ABO incompatibility???? Unless you do not have computer system or you are issuing during downtime? Link to comment Share on other sites More sharing options...
Malcolm Needs ☆ Posted January 2, 2010 Share Posted January 2, 2010 Most of the computer system should flag for ABO incompatibility???? Unless you do not have computer system or you are issuing during downtime?Only if the case is on computer already.If the patient is new, or was wrongly grouped before, or the present or previous sample was taken from the wrong patient, or the unit were incorrectly grouped, then NO! Link to comment Share on other sites More sharing options...
Eagle Eye Posted January 3, 2010 Share Posted January 3, 2010 OH yes...Malcom I should have added all if's and exceptions...... Link to comment Share on other sites More sharing options...
AMcCord Posted January 7, 2010 Share Posted January 7, 2010 Quick question about the CLIA regulation. We use gel for out antibody screens and crossmatchs. CLIA is saying that if you are using gel for crossmatching then you wil not detect ABO incombatibility. I am wondering how othe labs are handling this. You can do an immediate spin crossmatch in the ABO gel card. We do not currently do ABO gel we do tube method. I am tring to find out if it would be better just to go to immediate spin crossmathing and if all is negative then stop there. Or do I go to doing ABO and immediate spin crossmatching on gel and do the IGG crossmatch. What are others ****?Thanks,CassieWe used to do a tube type and immediate spin crossmatch with a gel antibody screen and gel AHG crossmatch. I vote for dropping the AHG crossmatch with negative history and negative antibody screen. There's plenty in the literature to support the safety of dropping the AHG crossmatch in that circumstance and it saves you plenty of time and $. Link to comment Share on other sites More sharing options...
Recommended Posts
Create an account or sign in to comment
You need to be a member in order to leave a comment
Create an account
Sign up for a new account in our community. It's easy!
Register a new accountSign in
Already have an account? Sign in here.
Sign In Now