Ortho Surgiscreen 2 reactions

[Byfaith]

We have recently worked up 3 different patients with 1+ to 3+ reactions in Surgiscreen 2 (lotVSS437) who have a negative ortho Panel A. Anyone else?

[David Saikin]

This question pops up sporadically; I have seen it rarely (but not recently). Personally, I think most of the time it is an HTLA type of reaction. Most that I have encountered have been in multiparous women. I could repeat the reactions when a specimen was referred to me AND I had the same lot of screening cels. I have also seen the negative Ortho panel become positive with the R2R2 cells if enzyme pretreated . . . and/or the reaction disappear after enzyme pretreament.

I still think gel and capture are way too sensitive.

[ElinF]

I don't know if this would help, but we were having issues like that with "miscellaneous reactivity". It was more of a reagent storage problem. We now rotate our stock of surgiscreen reagents every 2 weeks and store them in a darker location. (We bought a reagent holder that was clear and spray painted it black and it covers up the whole bottle.) We also don't let the reagents sit out at room temperature for long periods of time. The incidence of these reactions has decreased significantly.

[KBBB]

What is the donor number? Ortho may use the same donor for different lots of screening cells. We had an issue with VSS432 Cell #1 donor 308439 with a weak reaction. We sometimes resolve questionable results by diluting the 3% screening cell set to 0.8% for gel. If that is negative, we interpret as negative.

It seems to me that if it was a storage issue, then multiple patient plasmas would show the same problematic reactions.

We also have had the experience of sending a specimen to the reference lab for a 1-cell reaction, only to be told it's a cold autoantibody. It doesn't make sense to me that the cold auto would only react with 1 cell and not all three. The cold is there, but it isn't the explanation for the reaction. We also have had sample reactions that are explained by rouleaux, but it isn't always very obvious.

[Byfaith]

What is the donor number? Ortho may use the same donor for different lots of screening cells. We had an issue with VSS432 Cell #1 donor 308439 with a weak reaction. We sometimes resolve questionable results by diluting the 3% screening cell set to 0.8% for gel. If that is negative, we interpret as negative.

It seems to me that if it was a storage issue, then multiple patient plasmas would show the same problematic reactions.

We also have had the experience of sending a specimen to the reference lab for a 1-cell reaction, only to be told it's a cold autoantibody. It doesn't make sense to me that the cold auto would only react with 1 cell and not all three. The cold is there, but it isn't the explanation for the reaction. We also have had sample reactions that are explained by rouleaux, but it isn't always very obvious.

Donor # in question is 309452 - we have 0.8% Surgiscreen for Gel testing.

[Byfaith]

ElinF - Thanks for your reply! We already do the darker storage by keeping them in the box, and open a new set at least once a week. Room temp storage is more of a problem as they are in pretty much continuous use on 2 out of 3 shifts.

I like your solution for a reagent holder - do you know where you got it?

[ElinF]

ElinF - Thanks for your reply! We already do the darker storage by keeping them in the box, and open a new set at least once a week. Room temp storage is more of a problem as they are in pretty much continuous use on 2 out of 3 shifts.

I like your solution for a reagent holder - do you know where you got it?

I believe I got them from Market Lab? They are like a frosty color that has 5 reagent slots. There is an annoying handle that I had my husband saw off! I then painted it black. I just order and tweak to my needs! I couldn't find exactly what I wanted.

[KBBB]

We had another one of these issues today. 0.8% Surgiscreen Lot VSS439 Cell #3 Donor 309401. Reacted 2+. The Antibody ID sent to a Ref. Lab was negative. An Antibody screen using 3% set (Lot 3SS478) diluted to 0.8% for gel testing was negative.