Ever use pre-warmed plasma on the Echo?

[Karrieb61]

Hello again all Echo users, today's topic is pre-warmed plasma use on the Echo.   We have had a couple of known patients with HX of cold, non-specific antibodies where we have used pre-warmed plasma (heat block 30-60 min) and run the usual pre-warmed manual  screens, panels, and crossmatches. For the heck of it, our lead tech confirmed the colds again on both patients, prewarmed the plasma and ran panels and crossmatches on each by popping the warmed plasma into the Echo and running the tests individually (no other test of any kind on any patient loaded at the same time). In all cases, we got negative screens, panels, and/or crossmatches, just like we did doing the usual manual pre-warm technique with tubes.

 

Yes, I know this is not approved by Immucor but I am wondering if you run pre-warmed plasma anyway on the Echo. In order to make this legitimate, I want to validate this by doing a method comparison as we get more samples into the Blood Bank.  One of my continual concerns is that many labs run cold screens and panels routinely even though the vendors do not approve this using their liquid reagents (with the exception of the Ortho panel which permits a 15 degree cold). I would like to eliminate these all together since we aren't supposed to be concerned with IgM antibodies usually but if a patient has a strong cold, AND we can warm it up enough to run it on the Echo AND then get negative panels, or compatible crossmatches, then it seems like we have also ruled out misc. warm allo antibodies that may have been masked by the  cold.

 

What do you think?

[RWOOD57]

It has worked for me also, but I was just experimenting.  Please let us know if you get it validated.

[Karrieb61]

We too are experimenting still and maybe validating as we get more samples in. I pulled the SOP drafts back on doing it officially since we haven' validated nearly enough samples. Not sure where I am going to want to go with this yet. We've had a number of problematic patients lately, about 50% with no known, logical reason for things like fully screen units that are still incompatible, fully compatible crossmatches on patients with what looks to be strong warm autos on the Echo,  just too many odd scenarios all based around the Echo. The use of the term "solid-phase antibody" now makes sense to me so I am redoing some SOPs to allow tube testing when we just can't figure out what the heck to do. Kind of discouraging........