MOBB Posted March 25, 2017 Share Posted March 25, 2017 Which does your facility use and why? Link to comment Share on other sites More sharing options...
Dansket Posted March 25, 2017 Share Posted March 25, 2017 3-cell screen might mitigate the poor technique of non-blood bankers who do tube testing, but not necessary for manual or automated gel testing. All our testing is done on ProVue with 2-cell screen. Likewine99 1 Link to comment Share on other sites More sharing options...
John C. Staley Posted March 25, 2017 Share Posted March 25, 2017 We initially switched to a 3 cell screen because it made the transfusion service medical director more comfortable when we went to the immediate spin crossmatch. That was a long time ago and I don't know if the facility is still using the 3 cell screen or not. I suspect they are since inertia is the most powerful force in the universe which explains why blood bankers find it nearly impossible to change once the course is set. (This of course, was typed with a partial smile!) MOBB, tcoyle, AMcCord and 2 others 5 Link to comment Share on other sites More sharing options...
MaryPDX Posted March 25, 2017 Share Posted March 25, 2017 We switched to 2 cell screens when we went to gel about 15 or so years ago. ANORRIS 1 Link to comment Share on other sites More sharing options...
MOBB Posted March 25, 2017 Author Share Posted March 25, 2017 8 hours ago, Dansket said: 3-cell screen might mitigate the poor technique of non-blood bankers who do tube testing, but not necessary for manual or automated gel testing. All our testing is done on ProVue with 2-cell screen. Why do you say it might mitigate poor technique? My blood bank experience is mainly gel with 2 cell screens. ANORRIS 1 Link to comment Share on other sites More sharing options...
Dansket Posted March 26, 2017 Share Posted March 26, 2017 The was a white paper written by John Judd many years ago regarding 2 versus 3 cell screens. In this study, he observed that technique (tube testing) was a far greater variable affecting test tube reaction strength than the number of cells in the antibody screen. Since 3 cell screens are configured with more double-dose cells than 2-cell screens, it might mitigate the weaker reactions found by some individuals. John C. Staley and AuntiS 2 Link to comment Share on other sites More sharing options...
galvania Posted March 27, 2017 Share Posted March 27, 2017 It depends what type of population you are testing. If you are testing patients, then ideally you need to have those antigens where antibodies may only react against homozygotes present in a double dose. It is almost impossible to do that with just two cells - regardless of whether you are testing in gel or in tube. So, three cells for patients. Two cells is fine for donors where very weak antibodies are less important AMcCord, goodchild, exlimey and 1 other 4 Link to comment Share on other sites More sharing options...
AMcCord Posted March 27, 2017 Share Posted March 27, 2017 The Echo runs a 3 cell screen so we have continued to run a 3 cell screen for tube testing. Sometimes that extra cell means you've got the rule out you need for an antibody ID without running more than one panel on the Echo. John C. Staley, dragonlady97213, BankerGirl and 2 others 5 Link to comment Share on other sites More sharing options...
Likewine99 Posted March 27, 2017 Share Posted March 27, 2017 Two cell screen for as long as I can remember. It saved the organization quite a bit of money and we keep 2 panels in stock. Have been on gel since 1994 and automated BB analyzer for almost 13 years. Marianne 1 Link to comment Share on other sites More sharing options...
Dansket Posted March 27, 2017 Share Posted March 27, 2017 9 minutes ago, Likewine99 said: Two cell screen for as long as I can remember. It saved the organization quite a bit of money and we keep 2 panels in stock. Have been on gel since 1994 and automated BB analyzer for almost 13 years. Did you attend ORTHO's very first ProVue training session? Link to comment Share on other sites More sharing options...
Ensis01 Posted March 28, 2017 Share Posted March 28, 2017 Two screen cells for gel and tube. It was changed from three for cost reasons. Link to comment Share on other sites More sharing options...
ANORRIS Posted March 28, 2017 Share Posted March 28, 2017 I have used two cell screen for 30 years MaryPDX, Dansket and Likewine99 3 Link to comment Share on other sites More sharing options...
Malcolm Needs ★ Posted March 28, 2017 Share Posted March 28, 2017 As far as I can remember, in a 46 year career, I never used anything but a two cell screen. MaryPDX, Likewine99, MOBB and 1 other 4 Link to comment Share on other sites More sharing options...
goodchild Posted March 28, 2017 Share Posted March 28, 2017 On 3/27/2017 at 7:15 AM, galvania said: It depends what type of population you are testing. If you are testing patients, then ideally you need to have those antigens where antibodies may only react against homozygotes present in a double dose. It is almost impossible to do that with just two cells - regardless of whether you are testing in gel or in tube. So, three cells for patients. Two cells is fine for donors where very weak antibodies are less important I completely agree. I have no intention of switching to 2-cell screen, but these sorts of discussions always give me pause. We identify so many antibodies in patients who are transfused, where the reactions are only identifiable on cells with homozygous expression. On 3/27/2017 at 8:35 AM, AMcCord said: The Echo runs a 3 cell screen so we have continued to run a 3 cell screen for tube testing. Sometimes that extra cell means you've got the rule out you need for an antibody ID without running more than one panel on the Echo. I am also a fan of free rule out cells on the screen itself. TreeMoss 1 Link to comment Share on other sites More sharing options...
tkakin Posted March 28, 2017 Share Posted March 28, 2017 2 cell for gel for cost reasons Likewine99 1 Link to comment Share on other sites More sharing options...
Malcolm Needs ★ Posted March 28, 2017 Share Posted March 28, 2017 For all of those people who have switched to the two cell screen for cost reasons, have any of you had any trouble with patients having acute or delayed haemolytic reactions all over the place (first question) and is cost reasons a valid reason for switching from three to two (second question). Please be brave enough to answer BOTH questions. John C. Staley and AuntiS 2 Link to comment Share on other sites More sharing options...
DebbieL Posted March 30, 2017 Share Posted March 30, 2017 We have used 3 cell screens since the 90s. We switched from 2 cell to 3 cell when we went to immediate spin crossmatches. I think I remember my boss at the time said 3 would do a better job of detecting antibodies because of more cells with homozygous expression. We also use the screening cells as extra rule-out cells when we can. I don't plan on switching to 2 cell. Someone else can do that after I retire. Don't fix something that ain't broke. yan xia 1 Link to comment Share on other sites More sharing options...
AuntiS Posted March 31, 2017 Share Posted March 31, 2017 On 3/28/2017 at 2:52 PM, Malcolm Needs said: For all of those people who have switched to the two cell screen for cost reasons, have any of you had any trouble with patients having acute or delayed haemolytic reactions all over the place (first question) and is cost reasons a valid reason for switching from three to two (second question). Please be brave enough to answer BOTH questions. It was before my time, but... 1. We don't have hemolytic reactions all over the place. In fact, we rarely have delayed hemolytic reactions at all. It is always very exciting for us - great teaching tool as well for students - when it does happen. Maybe 1 every 2-3 years? 2. I would assume cost was a big part of the equation. We use gel (manual) so you do use a lot less cards with a 2 cell screen! s Malcolm Needs and Ensis01 2 Link to comment Share on other sites More sharing options...
kate murphy Posted April 3, 2017 Share Posted April 3, 2017 As John Staley stated, inertia is the strongest force in the universe! We've been doing a manual 3 cell since we went to IS XM, same as DebbieL. And then along came 'electronic XM' (sorry Malcolm) and inertia keeps us at 3 cell. Automated methods (Neo & Tango) are both 2 cell, but those methods are more sensitive. As with lots of things in the BB, it all depends on your medical director's comfort level... John C. Staley, Malcolm Needs, AMcCord and 1 other 4 Link to comment Share on other sites More sharing options...
jsaproni Posted April 4, 2017 Share Posted April 4, 2017 At other hospitals we always used 2 cell but when I came to a smaller hospital with all generalist they used 3 because they felt more comfortable and we only use tube. We now do IS crosses Link to comment Share on other sites More sharing options...
Annan Posted April 11, 2017 Share Posted April 11, 2017 Here in Australia we use 3 cell screen to comply with guidelines for computer release of product Annan Link to comment Share on other sites More sharing options...
Tabbie Posted March 8, 2018 Share Posted March 8, 2018 On 11/04/2017 at 6:40 AM, Annan said: Here in Australia we use 3 cell screen to comply with guidelines for computer release of product Annan Could you post the link to these guidelines? Thanks Link to comment Share on other sites More sharing options...
jalomahe Posted March 9, 2018 Share Posted March 9, 2018 Way back in 2003, the AABB published "Guidelines for Implementing an Electronic Crossmatch". In the section REQUIREMENTS on page 4 "Additional criteria suggested, but not universally accepted, include: ... The antibody screen should include a three- or four-cell sample." No further explanation was given but presumably it was for the reasons stated above that you are likely to have more cells with a homozygous antigen expression in a 3-cell panel than you are in a 2-cell panel. Most manufacturers of 3-cell panels make sure to include cells that are homozygous for Duffy and Kidd to avoid missing those. So long story short....that's why we use a 3-cell panel as part of our due-diligence of providing blood by computer assisted crossmatch. Malcolm Needs, Tabbie and yan xia 2 1 Link to comment Share on other sites More sharing options...
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