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Ortho Vision and MTS gel method


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We are getting an Ortho Vision installed today. I am wondering how many of you run Panel A and B on your Vision? Why or why not?

I also would like to know if anyone has a policy to incubate w-1+ IGG gel card reactions on antibody screens and panels for > 15 mins. Our policy which was already in effect when I became the manager is to reflex < 1+ reactions to a 40 min incubation. I don't think this is necessary and would like to discontinue the policy especially with the new Vision. I would like to see what others are doing. 

Bev Meadows

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We have had our two Visions for about 6 weeks now and love them!  We routinely run Panel A on them.  Each shift has two panels.  We take the panels out of the fridge and let them come to room temp.  The Visions are configured to reflex the panel when an antibody screen is positive.  (Note: if you have to manually review a positive screen, it will not reflex) When the instrument reflexes a panel, it will beep and the bubble will turn red if the panel is not on board.  That is our cue to load the panel.  We will put Panel B on if we want to run it, but it is not routinely taken out of the fridge until needed.  If we don't get clear-cut results with Panel A, we will use Panel B, or maybe selected cells to help confirm an antibody.

As for the second question, I have never heard of extending the incubation for weak to 1+ reactions on antibody screens and panels in gel.  I don't think this is necessary at all. Gel is very sensitive already and the instructions are for a 15 minute incubation.  I seem to remember reading that gel cards should not go past a 30-minute incubation due to dissociation of antigen-antibody complexes if formed. 

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We were told years ago that gel incubations could be extended to no more than 40 minutes.  I have validated this at both labs I have worked in.  We don't use it routinely but it is a tool in the box.  It can make a hetero E cell come up positive when it won't at 15 min.  It can also bring up those missing reactions with a Kidd antibody so you feel more comfortable calling it a Kidd.  HTLA-like antibodies don't get stronger with longer incubations.  The Vision's camera is VERY sensitive so I would think it is less useful than when doing only manual gel testing.

With all of the time your lab has been following this policy, you could have a lot of data on which to base a decision about its value.  How often have you found a 'real' antibody on the extended incubations?

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