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Gel antibody panel and tube antibody panels


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I think that is up to you and your Medical Director.  I have one 0.8% panel and two 3% panels.  I would rather convert 3% to 0.8% rather than the other way around.  I use Ortho gel and I have their "A" panel.  I prefer not to use it only because I find the Ortho cells to be extremely sensitive and occasionally get some spurious reactions that I do not find using other vendor's converted cells.  I primarily use the Ortho panel to r/o RhIg anti-D.

I also prefer the 3% panels using tubes if I have to deal with an autoimmune.  I can never absorb all the autoab out if I test in gel.  And, as I use the PeG autoabsorption I pretty much have to test in tubes.

Edited by David Saikin
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When we used gel, I converted 3% panels. I'm with David, I think that works better than trying to convert 0.8% cells to 3%. I keep Immucor 20 cell panels even now with solid phase. They seem to have a nice mix of antigens and the shipping schedule means I have 2 indate tube panels the majority of the time.

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13 minutes ago, SMILLER said:

Here we have one tube panel available at all times in addition to our three gel panels.  Gell is sometimes a bit problematic with cold autos and whatnot.  We also use individual cells from it to control antigen typings.

Scott

I agree.    When I got here their current procedure for a cold is to prewarm everything but still put it in a gel card.  I think that's just setting you up for failure.

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3 hours ago, David Saikin said:

I think that is up to you and your Medical Director.  I have one 0.8% panel and two 3% panels.  I would rather convert 3% to 0.8% rather than the other way around.  I use Ortho gel and I have their "A" panel.  I prefer not to use it only because I find the Ortho cells to be extremely sensitive and occasionally get some spurious reactions that I do not find using other vendor's converted cells.  I primarily use the Ortho panel to r/o RhIg anti-D.

 

Would it be weird to have an Ortho gel panel and a Quotient tube panel?  

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15 hours ago, mollyredone said:

We use Ortho screening cells, 1 0.8% and one 3% and 2 0.8% panels and 1 3% panel.  We rarely do a 3% panel, but do 3% screens if there are gel issues.  If we use the 3% cells for selected cells, we convert them to 0.8% and run them in gel.

We do the same.  It is super easy to convert 3% to 0.8%.  And, as I am sure everyone else does, we keep older panels and screening cells for extra cells if needed (our policy says we can use them up to 3 months expired as long as there is no hemolysis/turbidity)

s

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Without tubes, your ability to perform any problem resolution is very limited.....extremely limited. Rouleaux is a classic example: See it with Gel testing and there is nothing you can do except ship it out to a reference lab if you don't have tube testing available.  Time is wasted and additional costs incurred all for what would be a simple resolution if tubes were available.

Warm autos, cold autos, determining clinical significance of anti-M, anti-P1, anti-A1, rouleaux resolution...all of these can be resolved with tube testing.  The real question is, what is the cost vs benefit of having a 3% panel available if you only use it sparingly.

On a side note...our lab is not fond of Ortho cells.  They are very "sticky".  To a person, you could have a 12 cell selected panel from various manufacturers (which we routinely do) with Ortho cells intermixed, and we would be able to accurately identify Ortho cells on the first rock of the tube.  We use them, but only because our customers use them and there can be issues with Ortho's 0.8% cells in Gel testing that are reagent dependent and disappear when converting Ortho 3% cells to an 0.8% concentration.

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23 hours ago, amym1586 said:

Would it be weird to have an Ortho gel panel and a Quotient tube panel?

I have an Ortho A 0.8%; a Quotient 16 cell 3% and an Immucor Panel 10 3%.  I also have a Grifols 0.8% that they left here when I was trying out their equipment.

No, it would not be weird.

Edited by David Saikin
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23 hours ago, amym1586 said:

I agree.    When I got here their current procedure for a cold is to prewarm everything but still put it in a gel card.  I think that's just setting you up for failure.

You can't do a strict prewarmed in gel, though rarely I will prewarm my IgG card.  If I am using prewarmed technique I use tubes.

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We stock one gel panel and one tube panel.  Most of our testing in done in gel, but we have the tube panel to fall back on if necessary -- plus it gives us some more cells to use for rule/out cells when needed.  We have not found success when trying to do pre-warmed testing in the gel system, so we'll use our tube screening and panel cells for that purpose.  As we know, all is not clear cut when it comes to blood banking!

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2 hours ago, Malcolm Needs said:

Personally, I would have left out the word "strict", but that is just my opinion!

An opinion worth paying attention too, if I might be so bold.  Thanks - I know you can't do PW in gel, that's why I use tubes for the "strict" version.

Thanks M

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7 hours ago, StevenB said:

Without tubes, your ability to perform any problem resolution is very limited.....extremely limited. Rouleaux is a classic example: See it with Gel testing and there is nothing you can do except ship it out to a reference lab if you don't have tube testing available.  Time is wasted and additional costs incurred all for what would be a simple resolution if tubes were available

Granted you can't do 'saline-replacement' in Gel, but you can add additional saline to the gel card reaction chamber!

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Dansket, my understanding, and please correct me if I am wrong galvania, is that the ratio of red cells to plasma, and the dilution of the red cells are both "sacrosanct", and that if you change either of these, you run the risk of getting false positive or false negative reactions?

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35 minutes ago, Malcolm Needs said:

Dansket, my understanding, and please correct me if I am wrong galvania, is that the ratio of red cells to plasma, and the dilution of the red cells are both "sacrosanct", and that if you change either of these, you run the risk of getting false positive or false negative reactions?

Absolutely! I sometimes feel a bit uncomfortable about doing groups on whole blood where the patient has a low Hb - and I know it will still react properly. I wouldn't risk it for anything that could result in prozone.

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