Galileo vs Tango unspecific positive reactions

[MeganPLT]

Our hosiptal is thinking of switching from Galileo to Tango for multiple reasons, 1 being the amount of "false positive" reactions we get. Often we will get a 1+ or 2+ reaction on the screen and when we run the Ab_ID we either get random positive reactions that do not "match" an ab pattern or a completely negative panel, and when we run our alternate methodology the screen or panel is negative. (Note we are not talking about patients who have received rhogam recently.) I am wondering if Tango users are also having these types of issues since they are same methodology? From my understanding, tango uses intact red cells as apposed to a broken red cell membrane coated on the strip (galileo), many of these "unspecific" reactions do not show up on the tango, and I am wondering if this is true. Any thoughts

[maryofcalif2005]

Our hospital is thinking of switching from Galileo to Tango for multiple reasons, 1 being the amount of "false positive" reactions we get. Often we will get a 1+ or 2+ reaction on the screen and when we run the Ab_ID we either get random positive reactions that do not "match" an ab pattern or a completely negative panel, and when we run our alternate methodology the screen or panel is negative. (Note we are not talking about patients who have received rhogam recently.) I am wondering if Tango users are also having these types of issues since they are same methodology? From my understanding, tango uses intact red cells as apposed to a broken red cell membrane coated on the strip (galileo), many of these "unspecific" reactions do not show up on the tango, and I am wondering if this is true. Any thoughts

Hi Megan,

While no automated blood bank analyzer is "perfect" (just as no manual screening method is perfect) it is true that there are fewer "nonspecific" reactions on the TANGO's Solid Screen II strip methology than on the Galileo or GalileoEcho Capture R strip methodology. There is a distinct difference in the reagents used on the microwells and the manner in which the allo-antibodies are bound and detected.

There are 3rd party white papers of actual side-by-side studies performed in 2008 on these analyzers to support my statement. I don't know if the new owners of the former Biotest TANGO system (Bio-Rad Laboratories) still have access to, or distribute, those particular published articles. I have copies which I'm happy to share, if you'd like. I don't know how many current TANGO users are active on BBT to provide feedback. it will be interesting to see what other responses you get to this thread.

I have a clinical lab and donor center background as a Med Tech and previously worked for Biotest, so you might perceive me to be prejudiced. However, I'm no longer employed by Biotest (and no longer working for any blood bank vendor at this time) - so have nothing to gain personally by promoting one system over another. Both are viable and overall, get the job done. If that were not so, many labs today would not have Galileos and Echos, routinely reporting test results, as your lab has today.

I am aware of labs who have done side-by-sides of the 3 vendor's instruments and overall, chose the TANGO more because of it's ease of use, than because of a higher level of nonspecific reactions on other systems compared (Echo, Provue).

I do not believe that all Galileo and Echo systems are going to "go away", just because the TANGO has a slightly better statistical performance rating on antibody screening tests. As you know, blood banking is not an exact science. It is high complexity testing at its finest, with many nuances involved. Blood bankers, by and large, have strong feelings about the way they do things and don't like any vendor trying to tell them which system is best for their lab. Being a Med Tech myself, I respect that outlook.

There are pro's and con's to each test system, and to doing business with a particular vendor that manufactures and supports such a system. You and your team will have to hash that one over and come to your own conclusions. I'm just offering some facts and data, since my general manner of operating and making business decisions is based on gathering sufficient facts and data to make a logical decision, rather than an emotional one because "I like my sales rep". Hope this info is helpful.

[mammothbb]

Hi Mary,

We currently use the ECHO and are also getting the TANGO. I would be highly interested in obtaining copies of the side-by-side studies.

Thanks so much,

Julie

[AMcCord]

I would only comment that we are seeing a lot fewer funky reactions on the Echo since the upgrade that increased the incubation time and changed the volume of LISS used. Is there a study done recently and that compares current information? That's what would be most helpful.

[username2011]

Mary - I would also be very interested in obtaining copies of any side-by-side studies that you have access to. We are researching a few models ourselves and are having trouble finding valuable, independent perspectives. Thanks a ton in advance.

[BB1956]

Mary- I would also be very interested in obtaining copies of any side-by-side studies concerning the Tango, Echo, or Provue. We are in the process of evaluating Blood Bank Automation. We currently use manual gel and tube for back up. Sales reps have presented fewer false positives with the Tango but I have not had the opportunity to speak to any end users who have used the Tango for say one year. I think it takes at least a year for you to see some of the unique problems with any system you use. Would appreciate feedback from any Tango users.

[Norbert Ahrens]

I would like to hook up with you concerning the afore mentioned white papers. We had recently to choose between the platforms as they are available in Germany and use now the Ortho Gel as it is available in Europe. As we are still interested in comparisons, I would be very happy for a copy.

Norbert

[Steve N]

Hello Mary,

I would also really appreciate the papers you have with the side by side data, specifically of the 3 vendors(TANGO, ProVue, and Echo). Thank you in advance. You can email me at SteveNa_13@yahoo.com

[labgirl153]

Am new to Tango...long-time gel & tube user. Pros: It does not pick up on colds and anti-D due to RHIG as often as does gel. Two problems with Tango however:

1) Instrument loses connectivity to the server at least once every 24 hours causing the instrument to stop all testing and forcing operator to reboot. Loses most of the data in this process. If you're running stats or have a lot running this is a huge issue. One must start over or convert to gel testing. Could lose an hour or more time in the process. This is a busy lab in a trauma facility. We can't afford to have this happen. Am not sure when the next software upgrade is due or if more ram is needed in the instrument itself, but it's a major problem.

2) Reaction carry over. Ran a known antibody patient the other day (she has anti-E, c). One specimen running concurrently with that patient's also was positive in the same two cells. The two specimens running immediately behind the antibody patient ALSO were positive in the same two cells. Fortunately I realized the problem and did the three false-positives on the bench. All three patients were antibody screen negative in gel. Also put the tango through a rinsing cycle x 6 to flush out residue prior to using the instrument for new specimens. This is a huge problem. Imagine what would happen if other lab instrumentation was designed to allow this sort of carry over (chem or hem analyzers).

For routines this instrument is fine. For stats, known antibody patients etc. I would advise against its use.

[bmarotto]

We have been live with Tango for three weeks. We have two Tangos and have been getting connectivitiy issue on both. BioRad will be trying two things next week. 1. Placing shielding on the parallel cables to block electromagnetic interference. 2. Reinstalling the firmware. I will let you know if this helps.

We did not notice a problem with false positive reactions or carryover during validation or since we have been live. That is not to say we won't see these issues in the future.

[BANKTECH]

We are currently validating the Tango. We have not had problems with connectivity or carryover. So far, it is definitely better than the Galileo. Hopefully, we will think the same thing when we go live in a few months.

[tbostock]

I have had the Tango for about a year. Very happy with it. We still have some minor connectivity issues and COP warnings, but we hope this will get better with the next upgrade.

Overall, no issues with cold agglutinins or rouleaux. And fewer Anti-D due to RhIg.

We've picked up a couple Anti-M (IgM) in the Tango that did not show up at all in the gel. Interesting because the pattern of agglutination is unique on the Tango.

We have never had a carryover problem and tested this extensively during validation.

[bmarotto]

In looking back, our connectivity problems began around the time we had a new PC and monitor wall mounted next to one of the Tangos so the techs could verify exported results in the BBIS. Three months of testing, validating, and training prior to that PC being installed and there were no connectivity issues. I find this very suspicious. I have asked our BioMedical engineers if they have any kind of device for measuring electromagnetic interference. Maybe we will just turn the PC off for a few days and see if the connectivity issues dissapear.

[tbostock]

In looking back, our connectivity problems began around the time we had a new PC and monitor wall mounted next to one of the Tangos so the techs could verify exported results in the BBIS. Three months of testing, validating, and training prior to that PC being installed and there were no connectivity issues. I find this very suspicious. I have asked our BioMedical engineers if they have any kind of device for measuring electromagnetic interference. Maybe we will just turn the PC off for a few days and see if the connectivity issues dissapear.

We had a LOT of connectivity problems at first, found out our IT guy pinned our connector incorrectly. So check that. Once we pinned it correctly, they reduced drastically.

[bmarotto]

We had a LOT of connectivity problems at first, found out our IT guy pinned our connector incorrectly. So check that. Once we pinned it correctly, they reduced drastically.

Are you talking about the connector for the interface between Tango and your LIS? Our problem is the serial connection between the Tango and the Tango PC, causing the Tango software to freeze.

[tbostock]

Are you talking about the connector for the interface between Tango and your LIS? Our problem is the serial connection between the Tango and the Tango PC, causing the Tango software to freeze.

Yes, the connector between the Tango and the LIS. They originally thought it was the serial connection between the Tango PC, but the connector being pinned incorrectly was causing most of the issues. About once a day now, we get an interface error, but it does not cause us to initialize the Tango.

[bmarotto]

Ther error we get is "No connection to device via serial interface". Sometimes we also get "Installed version does not match the analyzer or system is turned off". We have not had any LIS interface errors. It keeps nagging at me that we never got these errors over the three months of validating and training. The only thing that changed just before the errors started was the installation of that new PC. If we turn the PC off for a few days and the errors go away then we'll have an answer....but will still need a solution!

[NFkappaB]

We have been live with Tango for three weeks. We have two Tangos and have been getting connectivitiy issue on both. BioRad will be trying two things next week. 1. Placing shielding on the parallel cables to block electromagnetic interference. 2. Reinstalling the firmware. I will let you know if this helps.

We did not notice a problem with false positive reactions or carryover during validation or since we have been live. That is not to say we won't see these issues in the future.

Hi, any update on the connectivity problem available? thx.

[bmarotto]

Hi, any update on the connectivity problem available? thx.

We are still waiting for the ferrite noise filters to be installed. BioRad is pretty sure there is some EM interference from the new PC that was installed next to the Tango. The timing of when we started getting the connectivity problem supports this theory.

[NFkappaB]

We are still waiting for the ferrite noise filters to be installed. BioRad is pretty sure there is some EM interference from the new PC that was installed next to the Tango. The timing of when we started getting the connectivity problem supports this theory.

Thanks for the quick reply. It makes sense. Seems to be a minor issue though. I would appreciate an update if the ferrite fixed the problem.

[ADawson]

Hi Mary,

We are also in the process of automating our blood bank. I too am interested in the side by side study of the 3 instruments. You can reach me at adawson@lenoir.org.

Thank You

[edralyn]

Hi Mary ,

I know this is an old posting but I am really interested to get a copy of those papers

my email ebernardo@rogers.com

[chrisbsbb]

Hi. I've had the good fortune to use Gel cards and Immucor Automation (all platforms). I have friends who have used the Tango and others who have used the Provue. They are all good tools but in our discussions I have come to appreciate just how much more sensitivity, quality, flexibility, and speed one receives when using Capture platforms. There are some differences between the platforms including manual Capture, Galileo, Neo, and Echo, but as whole I would not go to another automated platform after having used the Immucor products.

[chrisbsbb]

Oh by the way. I saw some of you were looking for the white paper comparing the different methods. I've never been able to get my Ortho rep to provide me such papers but my Immucor rep had a few. The one I can think of off the top of my head is the Weisbach paper published in Transfusion in 2006. I know it's a little older but all three manufacturer's had automation platforms included in the study.

[NFkappaB]

Hi bamarotto,

was shielding of serial cable succesful at yours?

thx and br