Nonspecific Reactions with Ortho VRA panel

[Erin]

We have had several Rh positive patients (4-5) in the past week that exhibt reactions that mimic anti-D in Ortho VRA190 gel testing.  These patients have reactions with 4 out of the 5 Rh positive cells.  All clinically significant antibodies are ruled out.  One patient did end up having a warm autoantibody with anti-D specificity, but all of the others have had negative autocontrols.  We end up calling them "undetermined" and perform AHG crossmatch.  Wondering if anyone has had similar issues with this panel.  Thanks.

[Yanxia]

What about anti-LWa.

[David Saikin]

I find the Ortho cells, in general, to be highly sensitive. I can run another vendor's panel at 0.8% and have no reactivity but the Ortho Panel(B for me) will give me reactivity - sometimes specific and sometimes not . . . it's a tough nut to crack deciding how to handle them. I think you are doing the right thing by performing the ahgxm. It's hard to disregard reactivity when found. Some folks go to a less sensitive method (PeG) to get negative reactions - my feelings are "why are you running a very sensitive test only to ignore result?"

Try running some Rh= and Rh+ cord cells with your pts - Shily has a good point.

Edited January 20, 2014 by David Saikin

[R1R2]

Yes, we are seeing nonspecific reactions, sometimes in a C pattern.