Peg and LISS

[gilmanch]

Hi everyone,

 

Does anyone have procedures to give helpful hints or other source to know when it is best to use Peg, LISS or anyother potenatoirs?

Some antibodies are better with others and want a good cheetsheet to have in place to help, especially since we just introducing Peg. Do you use Peg as 1st option when needing tube? Peg cant be read at 37 so if want to know if antibody is reacting at 37 need to use LISS.

 

Anymore to add???

 

Thank you!

[Dr. Pepper]

Assuming you don't have gel or solid phase, that leaves you in a tube (like us). I would use LISS or PeG. PeG is in general more sensitive, particularly with Rh and Kidd system antibodies. Some years ago we trialed PeG extensively before settling on LISS for routine use. While the added sensitivity was nice, it was also very good at enhancing autoantibodies and some colds. We also found occasional specs which showed weak, unspecified reactivity which we could not replicate with other techniques, even sending it to a neighbor to test in gel. There can be difficulties in testing plasma with PeG. So we stuck with LISS. We keep PeG on hand to use with weak antibodies which may be hard to pin a specificity on with LISS, for non-RBC antibody problems with something in the LISS formulation, to enhance eluates from weak positive DATs, and to do autoadsorptions.

I wouldn't worry about not being able to read PeG at 37o. If it's significant you should see it in AHG. My advice would be to pick one or the other to use routinely, and keep the other on hand as a backup in case you have some technical issues with the routine methodology.

[tbostock]

Agree with Dr. Pepper. I would probably pick PeG as my primary method for the reasons that he states.

[David Saikin]

As Dr Pepper says, sometimes PeG can be a bit too sensitive.  When it was first released I would only allow it to be used in certain circumstances - we used LISS as our primary enhancement for tubes.  If your pt has an IgG in their system you may end up working up autoabs that you would not find with LISS . . . You'll just have to determine the level of sensitivity you want for your routine screening procedures.

[AMcCord]

When our primary method was gel we used LISS for backup, reserving PeG for problem solving. Now that we've switched to solid phase, we use PeG for backup and LISS for problem solving (those pesky autos that show up with solid phase and PeG). Solid phase and PeG are closer in sensitivity. PeG does have a learning curve, but my generalists are using it with no issues.

 

My advice is to pick one method as your primary and use the other as the problem solver. Both will work well.