Looking for thoughts on completing ABIDs, specifically whether it is ideal to use selected cells from the original methodology.

Our transfusion service currently uses solid phase as our primary method of testing as well as PeG. It seems of late that it is becoming increasing popular among staff to shotgun ABIDs and throw in Extend solid phase panels and PeG when faced with anything less than straightforward reaction patterns on an ID, rather than carefully selecting cells to complete rule outs. The end result is often confusing and makes it hard to review past work...

It seems like there is a definate need for coaching here, but we are also looking at proposing reducing ordering of our panocells reagents not only to save money but with the possible added bonus of redirecting techs away from jumping straight to PeG unecessarily while maintaining it as an option for patients where it is truely needed.

I would love to hear what other folks think about choosing the methodolgy for selected cells and ways to minimize throwing everything at an ABID.

Yeah, sounds like some education is needed. The shotgun approach is sometimes easier for someone who really doesn't understand what they are looking for in rule-out cells. Also (and I see the same problem here) is that they will do the first panel in gel (our primary method here) and then do the rule outs on another panel in tube because they didn't want to convert the cells to 0.8%. I tell them that's like "apples and oranges" if your rule outs are done in a different method...are the rule outs negative because the antibody is not there, or are they negative because tube testing can't pick them up?

My problem with the gel method, is that the initial reactions may not be what they actually are. By this I mean if the cards are spun a second time, the reactions may change. How do you interpret the reactions if this happens? Or are you to leave your initial reactions alone, even if questionable?

Even though gel cards are not supposed to be spun twice I realize this happens sometimes.

Go with the initial gel rxns and weed out something if it muddies the waters.

I've seen the shotgun approach used by techs who aren't always sure of themselves in BB and are trying to juggle multiple duties, both in and out of the BB.

We do not spin gel card twice...almost never. Our process is to run gel panel (A), and use select cells from panel C or pano cell by Gel.