Gel users, what do you do when you get a mixed field reaction in the antibody screen?

I would check the sample for fibrin, respin and retest. If it's still mixed field I would test with tubes.

Mixed fields are often due to cold agglutinins.....my 'theory' is that some cells get sensitized before plasma/cells warm up OR some antibody dis-associates during incubation leaving you with some positive cells and some negative. Try prewarming (may have to resort to tube method since 10 minute spin at room temperature won't help with the strong colds).

Rouleaux could also cause this 'look' - would have to go to the tube method for this one.

Hi Folks,

I agree with the others here that you really cannot interpret a mixed field on the gel, and need to do the testing with a tube method.

It could hint at Rouleaux (so be careful with immediate spin tests) or cold antibodies (you may need to go with a pre-warm technic).

I have never seen it, but mixed field on an auto control in gel (we only run the auto when performing an antibody ID) could be due to a patient's antibody reacting to recently transfused cells.