Gel antibody panel and tube antibody panels

[amym1586 118]

If we currently only have Gel antibody panels  how important is it to bring in a tube antibody panel ?

[pinktoptube 48]

Are you converting 0.8% cells to 3% for the tube method? Not quite sure what is meant by importance.

[amym1586 118]

We convert the 0.8% screening cells to do a tube screen. 

Important as in, we're currently living without it.  But should I have a tube screen in house? I guess we could convert the 0.8 panel cells. But man that sounds like torture.  

[yan xia 196]

I am in China, I don't know the rules or regulations in the USA.

I will keep tube as a backup since gel method sometimes are too sensitive and easy to be interfered by some factors, such as cold antibodies, proteins or sickle cells.

[David Saikin 1,432]

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 February 4, 2016 by David Saikin

[AMcCord 1,289]

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.

[SMILLER 870]

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

[amym1586 118]

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.

[amym1586 118]

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?  

[Malcolm Needs ★ 4,910]

1 hour 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 are not kidding it is!!!!!!!!!!!!!!!!!!!!!!!

[SMILLER 870]

1 hour ago, amym1586 said:

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

 

[SMILLER 870]

Don't see why.  We use Ortho gel and Immucor tube.

Scott

 

[tbostock 1,063]

2 hours ago, amym1586 said:

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

Nope.  I think it's a great idea to have different methods and different manufacturers.

[mollyredone 318]

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.

[AMcCord 1,289]

I converted Immucor cells for use with gel for ID panels for years and for antibody screens for 2 years. Worked great.

[AuntiS 81]

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

[StevenB 118]

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.

[David Saikin 1,432]

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 February 5, 2016 by David Saikin

[David Saikin 1,432]

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.

[TreeMoss 71]

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!

[Malcolm Needs ★ 4,910]

1 hour ago, David Saikin said:

You can't do a strict prewarmed in gel, though rarely I will prewarm my IgG card.

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

[David Saikin 1,432]

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

[Dansket 429]

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!

[Malcolm Needs ★ 4,910]

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?

[Auntie-D 363]

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.