Blood Bank Saline Problems

[07schrsam]

If anyone had any input on this, I would love the hear it.

 

We recently had some trouble and I was wondering if someone could help me.

 

Our cells washer stopped working.  We began washing Du's and Antigen testing by manual means.   On the third wash, techs were reporting that the cell buttons were not properly froming and the cells were 'stuck' to the side of the tubes.  If you were to add AHG, the testing performs as expected and the cell buttons formed.  I had no reports prior to the cell washer not forming buttons.

 

Initially this was on anti-D from Ortho so I got some Immucor anti-D in and it worked!  So, I blamed Ortho's anti-D and called the issue resolved.

 

Then, a tech reported that her Kell typing was not washing correctly and cells were washing away (sticking to side) on third wash.

 

Therefore, I moved to thinking there was a problem with the saline.

 

We buy non-buffered saline with preservatives.   I called the technical support for Cardinal Saline (that we were using) and they said there was reports of this happening but didn't give suggestions on resolution.  I tested the pH of the saline and it was barely a 5.0, which I sought as way to acidic.

 

Therefore, I got some new, buffered, saline in.  Initially everything was working fine with it until our weekly supernantant checks where we just wash check cells with saline once, and examine for a cell button and supernatant appearance.   We found the new, buffered saline,  is now causing cells to 'stick to the side' and not form good button.  We still had our old saline sitting around and now all testing is working and its supernantant checks look great on it.

 

WHAT IS GOING ON?!?!?!?

 

 

 

 

What I know.

RPMs were good on all centrifuges.

I used different manufactuers of Check Cells to rule out a bad lot.

I used different tube types in testing to rule out 'contaminated' tubes.

 

The only thing I feel it could be is the saline.

 

Thoughts?

 

Thanks!

[Dansket]

What brand/model of Cell Washer are you using?  I would replace/clean/bleach all the tubing from the saline container to the dispense nozzles in the cell washer.  I would clean/bleach all the nozzles in the washer.

[carolyn swickard]

Was there any movement between plastic or glass tubes - you weren't clear on that.  What is your level of static electricity like?  Do all of the techs wear gloves and jackets or only some?  Just a couple of guesses.  We have such high static levels that we had to get Ionmasters in place in order to get reagents to "drop" in the tubes.  Have your humidity levels been bouncing around?  

 

We have some problems with "sticking to the tubes", but it tends to be only with PEG manual tube testing.  Doesn't sound like that is your problem.  Good luck.

[07schrsam]

I tend to lean away from the cell washer since it is back to working fine.  There could be some static....we are in Northwest ohio where winter is upon us.  Thanks for the comments.