Expired Panel Cells

[kell23]

Would anyone be willing to share their procedure for the usage of "Expired panel cells" for antibody identification? I was recently inspected by the State and have to put a policy in place to use expired panel cells. I know using expired reagents is not the best solution, but sometimes necessary depending on the number of antibodies a patient has and also for Lua's, Jsa's etc... We always perform an AHG XM, we are not AABB registered facility. Any help would be appreciated. Thanks.

[Malcolm Needs ☆]

Would anyone be willing to share their procedure for the usage of "Expired panel cells" for antibody identification? I was recently inspected by the State and have to put a policy in place to use expired panel cells. I know using expired reagents is not the best solution, but sometimes necessary depending on the number of antibodies a patient has and also for Lua's, Jsa's etc... We always perform an AHG XM, we are not AABB registered facility. Any help would be appreciated. Thanks.

If, as I suspect, you are using these cells to rule out or rule in an antibody that cannot be ruled in or out on your current panel, either because the antigen is not expressed, or is expressed but on a cell that is reacting already with another antibody in the patient's plasma, then you would have to show that the antigen is still detectable.

For example, if you are using a cell because it is Lu(a+), you would have to show that it is still reactive with a grouping anti-Lua, with appropriate positive and negative controls.

:):)

[LaraT23]

Not sure about state regs but for CAP, the regents in question that are used past the expiration date must be classified as "rare" in a policy. Listing those items, select cells included speficially is necessary. See my attach ment!

The statement is on page 4, sorry it is a very lengthy procedure.

Antibody ID.doc

[adiescast]

We do what Malcolm suggests. If you use a reagent cell to rule out (or in) an antigen, you have to antigen type the reagent cell for the antigen in question to show that it is still present as expected.

This does not work so well for solid phase panels and I do not have a good solution for that. I imagine that gel (or CAT) would have similar limitations. Any ideas would be appreciated...

[kell23]

What if you do not keep Lua and Jsa antisera on hand to QC expired panels?? Is AHG XM compatible acceptable?

[David Saikin]

You could qc them using your procedure for qc of your ab screen cells.

[AMcCord]

I would also suggest that you put a limit on the age of the cells used, maybe expired no more than 2 or 3 months. Check appearance for hemolysis, discoloration etc. when used.

[Malcolm Needs ☆]

What if you do not keep Lua and Jsa antisera on hand to QC expired panels?? Is AHG XM compatible acceptable?

I would say no.

:o:(:o

[KKidd]

Our procedure states that: Selected cells are never used as the sole source of reagent cells for antibody identification, but are used as an aid to confirm the presence/absence of suspected antibodies.

This seems to work for JC and AABB inspectors.

:boogie::boogie:

[AMcCord]

Our procedure states that:Selected cells are never used as the sole source of reagent cells for antibody identification, but are used as an aid to confirm the presence/absence of suspected antibodies.

This seems to work for JC and AABB inspectors.

:boogie::boogie:

Yes, that is an important addition. My procedure also includes a similar statement.

[kell23]

Our procedure states that:Selected cells are never used as the sole source of reagent cells for antibody identification, but are used as an aid to confirm the presence/absence of suspected antibodies.

This seems to work for JC and AABB inspectors.

:boogie::boogie:

I included something to this nature in the procedure I just wrote. A friend had called CAP and they stated you had to QC expired panels but not the primary panel used since that was used in conjuction with the antibody screen. We would never used just expired cell panels and any questionable or inconclusive get sent to our reference lab.

The Ortho screening cells hardly ever have positive cells for Lua and Jsa, that's were the problem comes in for our lab.

Thanks for everyone's help.