Calling all ECHO users

[clmergen]

We actually have a call into Immucor about this. I am expecting a call back tomorrow (our choice to wait until tomorrow). We have had 15 screens positive with Lot 88, all but one had reactions on either Ready ID 127 or Extend II DN40. All clinically significant antibodies ruled out, all were negative in tube using LISS.

[sdarmor1]

What are your facilities doing about these "nonspecific" antibodies??? Are you designating them as unidentified and doing AHG crossmatches or are you considering the Ab screens to be negative? We use a computer crossmatch here for our patients with negative Ab screens. Glad to hear we aren't the only ones chasing our tails, still not interested in returning to Gel at this point.

[clmergen]

We call the ABSC positive. We result an Antibody ID as a "Footnote" and say "The Indiret Antiglobulin Test for "unexpected" antibodies shows non-specific reactivity using automated solid phase methodology but no manual tube methodology. This has no clinical significance". Then we AHG crossmatch and will be doing a Deviation Report for our Medical Director to sign.

[fgrano]

I still say this happens all too often, and that Immucor should aggressively be in effort to reduce the incidence. I continue to believe it will eventually become a marketing issue for them.

[heather914]

I rotate once every 6 weeks into Blood Bank but have a lot of experience in Blood Bank. We have been using the ECHO about 9 months and I have had very little hands-on experience with it. We recently had 3+ reactions in 2 of 3 screening cells. Tube testing for LISS and PEG were negative. We did an ECHO panel (we're not validated to report panels yet) and got an almost perfect Anti-Jka. DAT was weak positive and eluate demonstrated the Anti-Jka. Did not have enough specimen for tube panel although I'm pretty sure that would have been negative. Is anyone having similar experiences and wondering how many Anti-Jka's our tube testing has missed???

Edited May 22, 2010 by heather914

[AMcCord]

I rotate once every 6 weeks into Blood Bank but have a lot of experience in Blood Bank. We have been using the ECHO about 9 months and I have had very little hands-on experience with it. We recently had 3+ reactions in 2 of 3 screening cells. Tube testing for LISS and PEG were negative. We did an ECHO panel (we're not validated to report panels yet) and got an almost perfect Anti-Jka. DAT was weak positive and eluate demonstrated the Anti-Jka. Did not have enough specimen for tube panel although I'm pretty sure that would have been negative. Is anyone having similar experiences and wondering how many Anti-Jka's our tube testing has missed???

This is not an oddball experience. You will find an antibody now and then that is detectable with solid phase that is too weak to ID (or even detect) with tube testing. We've seen anti-Jk(a), -E, and -Fy(a) this way. I just picked worked up a patient specimen with an anti-Go(a) that is not reliably detectable with tube testing - PeG or LISS.

[fgrano]

We too have found ECHO to be particularly adept at identification with regard to "kidd." Though this is a minor part of our continued "non-specific" ECHO dilemma. More often than not, when tube is negative, ECHO's panel is unrevealing.

[banker]

We have been using the Echo's for about a year and we have always had this problem. Large numbers of positive screens were run using the Ready ID only to find nothing there! To make matters worse, we would repeat the screen and often it would be negative. The reproducibility of these machines has been a huge problem for us.

[banker]

That message was meant for a previous post about positive screens having negative panels.

[kmh76]

The Echo most certainly picks up Cold Antibodies as we have seen alot of this in the past. Our screens will be all 3-4+ and same with the panels. We then take it to the bench and do a full panel IS, 37 AHG, 4C. Most of the time it is a cold. We were told by Immucor that the Echo did not pick up Cold Antibodies. Don't believe them!

[L106]

We have had our Echo for three years now. Our experience has been that yes, sometimes the Echo will pick up Cold Autoantibodies. However, what we see more frequently is that many Cold Autoantibodies detectable by PeG/Tube technique are not detected by the Echo.

[AMcCord]

We have had our Echo for three years now. Our experience has been that yes, sometimes the Echo will pick up Cold Autoantibodies. However, what we see more frequently is that many Cold Autoantibodies detectable by PeG/Tube technique are not detected by the Echo.

Same for us.

[Dr. Pepper]

We are starting the process of picking a small volume BB analyzer (Tango, Echo, Provue). This has been a most helpful thread. Has anyone had experience with multiple platforms to able to say, "If I were you I'd pick....", and has anyone successfully interfaced with Meditech?

[bbbirder]

I have not worked with the Provue, just manual gel, and I don't know about the Tango. We have an Echo and love it. Now and then we have some non-specific reactions, but I think it is less than with Gel. We are interfaced with Meditech (Magic 5.64PP5).

[Dr. Pepper]

I have not worked with the Provue, just manual gel, and I don't know about the Tango. We have an Echo and love it. Now and then we have some non-specific reactions, but I think it is less than with Gel. We are interfaced with Meditech (Magic 5.64PP5).

Thank you - and I guess I should have specified Meditech CS (5.65), not Magic.

[fgrano]

Indeed, we remain in favor of our choice or this analyzer, and have of late had less such non-specific troubles. Recently, however, we had both the centrifuge and camera replaced and the machine has been functioning better than when first installed. The service rep reported that they have replaced many camera's, and that most such difficulties seem centered on this component - as would be expected. We have also learned that the centrifuge utilizes different RPM's for different functions, and that inefficiency here may well show first in the Anti-B well - likely owing to titer / avidity of the reagent. Of course these are our opinions, based upon a growing experience with the instrument. Technical support was most helpful in working through the difficulties. I too know nothing of the TANGO but hope to learn some day. HooRahhh

[KKaim]

We are starting the process of picking a small volume BB analyzer (Tango, Echo, Provue). This has been a most helpful thread. Has anyone had experience with multiple platforms to able to say, "If I were you I'd pick....", and has anyone successfully interfaced with Meditech?

I just recently started employment at an institution that uses ECHO. I have to comment that I am not very familiar with the ECHO. We have had some issues with the ECHO, but service is working through them with us. I previously worked at an institution that had the ProVue. I have to say that I like the design of the ECHO better on the note that you have to wait for the ProVue to stop or reach a certain point before it will let you add and reagents, cards, or samples. With the ECHO, you can add them at any time. I believe that the Tango allows you to do the same. I only know a little about the Tango, so unfortunately I can not give you my opinion. Although I believe that the methodology for the ECHO and the Tango are similar.

[jtemple]

I may be way off base, but this sounds like a drug reaction.