JustaKIDD

Yes, this is a known limitation of  automated analyzers in blood bank. 

You can now edit QC on the Vision.  You may also use User Defined QC.  Whole blood samples for Blood Bank and hemolysis can be problematic with any vendor or homemade creation.  The AlbaQ has less problem when stored in the upright position during storage, even the vials not yet in use.  It is very reliable and there's the ease of use with standard results and barcoding.

But since you have learned about novel antigens, maybe in your spare time you could write a (wait for it!)  NOVEL!

We are the only lab doing titrations for a 150 miles.  If we change to gel we will contact all of our OB/Gyns and the perinatologist that comes here periodically to explain our change plus put interpretive information in the report comments.  This is why I have never done them in gel before.  Doing them on the Vision would be convenient but all titrations on it are carried out to 10 dilutions (plus neat and a control) so it would have to be worth using up all of the reagent cells that it would require.  The variability of the endpoint plus the comments above about proficiency testing makes me hesitate even more.  I do see that gel titers are reported separately on the PT results now.  There is even a uniform method in gel. Ipregeno, were you submitting results under the gel uniform procedure and still getting too high?

Why would you want to switch from gel?  If you go to solidphase, you don't have a mirror back-up to run on the bench. Furthermore, its quite the learning curve to move from gel to reading/reviewing solidphase, particularly with the '?' and NS the plaques solidphase (search on this site to see all the posts) Staying  with the same vendor will minimize new vendor qualitfacation, validation (on bench), etc. Gel historically has been the easiest to read, interpret and train-particularly when you have generalists as you mention that are more used to pipetting (bench method at least). Check out the MDBuyline data, it has given the VISION great reviews recently. 

Be careful as the diluents used to suspend the cells will be different.  For gel card assays you need a Low Ionic strength diluent.  Diluents often contain potentiators and will have been validated for use in the appropriate card system.  I am not saying they won't work and they probably will however you should perform validation to ensure you don't miss a significant antibody. 

I completely agree with the variability of Bg antigens on the red cell, as the most common cause of these types of reactions. Even though Ortho screens for these- they can come and go on the red cell in terms of their expression strength. We must not forget  a strong 'I' expression; a strong cold agglutination  w/ 'I' specificity -can be a common causal issue for these type of reactions-and something manufacturers don't routinely type for. Changing manufacturers will not solve the problem, as you'll note by doing research on this site- they are all plaqued by this sometimes .... The joys of blood bank- and the need for knowledgeable techs!!!

Karrie61-in addition to gel- you may want to consider the other solidphase method (not sure why you mention you do not want solidphase). If it's due to the AUS problem with your ECho-the two solid phase automated methodologies ( capture R used on Echo/ Neo vs SSll on TANGO) are completely different in the detection of non specifics. Since TANGO uses intact red cells- not antigen coated ( stroma) micro wells- it does not have the false positive issue that CAPTURE R does. You may want to consider– although both the Vision and the TANGO are going to be bigger than your Echo. Anything smaller , will be a manual or semi automated platform nearterm.

Karrie61-in addition to gel- you may want to consider the other solidphase method (not sure why you mention you do not want solidphase). If it's due to the AUS problem with your ECho-the two solid phase automated methodologies ( capture R used on Echo/ Neo vs SSll on TANGO) are completely different in the detection of non specifics. Since TANGO uses intact red cells- not antigen coated ( stroma) micro wells- it does not have the false positive issue that CAPTURE R does. You may want to consider– although both the Vision and the TANGO are going to be bigger than your Echo. Anything smaller , will be a manual or semi automated platform nearterm.