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Mabel you have a point but still my mind goes in the direction of goodchild.

It is not possible to test every day, every antigen on every cell you use.

But we can follow the directions of the company selling the panel. If the campany can sell a panel that can be used for 2 months it is a big positive selling point (compaired to the other company's). They do not stretsch the time you can use the panel because they can not clame the antigen prsentation is good enough. Why is almost everbody that uses a panel then stretching that time, do they know better than the company (even without proper controls)?

Is anyone using reagents for Hb or any other test, that is expired? Then why do we do it for ABID panels. I do no see the difference.

Peter

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It is just a "possible" method to demonstrate the Panel's reactivity. Otherwise, you could test the antigen on the cell you are wanting to use to rule-out (i.e. C-, Jka-, S+) with a weak anti-S, but as has been pointed out, you may not have the reagents and/or staffing to do that.

Brenda

Just because the Jka or C antigens were up to snuff, does that mean the S antigen would still be detectable?
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  • 2 weeks later...

Mabel you have a point but still my mind goes in the direction of goodchild.

It is not possible to test every day, every antigen on every cell you use.

But we can follow the directions of the company selling the panel. If the campany can sell a panel that can be used for 2 months it is a big positive selling point (compaired to the other company's). They do not stretsch the time you can use the panel because they can not clame the antigen prsentation is good enough. Why is almost everbody that uses a panel then stretching that time, do they know better than the company (even without proper controls)?

Is anyone using reagents for Hb or any other test, that is expired? Then why do we do it for ABID panels. I do no see the difference.

Peter

Totally agree Peter.  Why is it OK to use expired panel cells with out QC?  This is going to go the way of the 30 minute rule.   

Edited by R1R2
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I love this discussion! I am caught in the same dilemma. However, I view it in terms cost/benefit. If do not use expired cells, there is a chance that I cannot positively identify many antibodies in my lab. We cannot afford to keep 6 indate panels for selected cells. If I only use indate panel cells for ruling out, then I have to either send many specimens to a reference lab for definitive ID or supply antigen negative blood for any antigens that cannot be ruled out using indate cells. Either option is VERY expensive.

My mentor said that at her hospital, they did a study and determined that panel cells within a certain number of days of expiration (I can't remember the # of days) were viable for use doing rule outs. Her policy is to use reagent cells within that time frame and then discard. (I do not know her sample size for the study).

I am leaning towards this option. I simply cannot afford to completely discontinue the use of expired cells for ruling out. Nor have I been cited by a regulatory agency (JCAHO,AABB) for doing so.

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I am leaning towards this option. I simply cannot afford to completely discontinue the use of expired cells for ruling out. Nor have I been cited by a regulatory agency (JCAHO,AABB) for doing so.

Were you not cited because the inspector(s) didn't have a problem with the process or was it because they didn't specifically come across this practice during their inspection?

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Everwhere I have worked uses expired panels to rule out/in antibodies.  The cost of keeping enough in-date panels to work up all anitbodies would be enormous.  AABB, CAP and FDA have all inspected these sites numerous times with no problems and I do know at least once FDA was looking at antibody work-ups.


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Were you not cited because the inspector(s) didn't have a problem with the process or was it because they didn't specifically come across this practice during their inspection?

I don't know the answer to your question. both inspectors had full access to all our records, policies & procedures and results. 

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  • 1 month later...

We use expired panel cells for rule-outs up to 4 months.  We did get cited by CAP for not running controls, so we had to change our SOP to included QC of the panel used. Usually a D+ cell with Anti-D and a D-control (either saline or dilute albumin).

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We use expired panel cells for rule-outs up to 4 months.  We did get cited by CAP for not running controls, so we had to change our SOP to included QC of the panel used. Usually a D+ cell with Anti-D and a D-control (either saline or dilute albumin).

 was CAP ok with your resolution to this deficiency?

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Another QC Method I have used is: On the outdated panel, run a cell that is positive (and reactive) for the "known" antibody and look for a similar strength of reaction. For example, let's say the patient has Anti-Jka reacting 2+ (indated panel), Anti-C reacting 1+ (indated panel), and you are using your outdated panel to rule-out Anti-S (so would need to run a cell that is Jka-, C-, S+)....you would also test a cell that is Jka+ or C+ and see if the strength of reactivity on the outdated panel is comparable to the strength of reactivity on the indated panel. That would be your control cell.Just a thought...Brenda Hutson, CLS(ASCP)SBB

We do the same. Patient sample is the QC.

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  • 3 weeks later...

Our SOP allows us to use expired cells for rule outs up to 90 days past the exp. date.  We also must QC the particular antigen we are interested in by using commercial antisera to be sure the antigen is still viable.

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