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Jessica A

Choosing an anti-D reagent

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Currently, my 200 bed regional hospital 45 minutes outside a metropolitan city uses Immucor Series 4 which contains MS201 and MS26 clones.  I'd like to change vendors due to pricing.  We only do weak D testing on cord samples or the rare investigation into a strong positive Fetalscreen sample or prior type discrepancy.  I want to make sure we choose the most appropriate cost effective reagent for our hospital population.  Does anyone have any suggestions on what to choose in the hospital setting?  Maybe some pro's and con's for the different clones?  Feedback on reactivity strength, etc?  I'm considering the Bio-Rad blend.

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What is your primary test method?  We tried the Bio-Rad blend several years ago and didn't like it.  We were using gel at the time and initially had good correlation between our results, but shortly after we switched it out, we had many patients who were Rh positive in gel and were Rh negative in tube (we used the tube reagent to perform retypes on new patients).  Inevitably, they would be positive after incubation at 37, but our techs were very frustrated because we were getting so many discrepancies between the two methods.  We switched back to the Immucor monoclonal blend and were much happier.  We have since switched to the Echo for our routine testing, and use the Series 4 reagent in tube if needed to save from stocking a third anti-D reagent, and we are again getting a few discrepancies with testing previously performed in gel, but that is much less frequent.

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We do our screens in gel but all of our ABO/Rh and rare antisera testing is in tube.  So we wouldn't be changing methodology, just clones.  I know each clone has it's own quirks.  I'm hoping with our patient population that we wouldn't see a lot of discrepancies by switching clones.  When we move to automation in a few years, I'm a little more concerned about discrepancies.

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