Was wondering how folks who are performing titers in gel have handled the situation of indicating to the docs what titer values should be considered a cause for possible intervention. The ACOG bulletin concerning Management Of Isoimmunization in Pregnancy indicates that a Coombs titer of 32 be considered significant in this respect. The bulletin does not mention any specific antibodies but I believe this would apply only to Rh. In light of the higher gel titers would you now be telling the OBs that 128 is the new baseline?

Has anyone evaluated gel titers and made the decision to stay with tube? Thanks!

The technical manual does not recommend performing titers in gel. I would say at minimum before making a decision to use gel to perform titers you will have to determine how you are going to perform titers in gel. If you perform titers as stated in the technical manual how will you translate that to gel. Will you incubate in tube and then pipette to an Anti-IgG card? What about possible errors you are introducing by adding a step like that. You are also going to have to run some parallels to see how strong the difference is.

My facility uses gel but we do not perform titers in gel.

Hope this helps

We were using gel for titres .... until we were 2 over our proficiency testing result and cosistently higher (1 to 2 tubes) than the private lab physicians sent their patients to. In Ontario, Canada Q-MPLS gives us provincial standards to meet, they stated the tube method from AABB Technical manual is "gold standard" and should be followed.

We use tubes for titers. Too much work to validate for gel and provide meaningful data to the docs. Unless there are more documented studies I can't see a conversion.

Like David, too much work to validate if switching to cards. Tubes still work well...