We have recently had a couple of problem patients come up with a strong 1+ incompatible crossmatch units in gel using the Provue. A couple techs will do the crossmatch AHG via tube using LISS and get a compatible crossmatch. Our director is kind of ify about them using the tube to get compatible reactions when gel is clearly incompatible. Any suggestions on any other methods that can be used?

I would be quite comfortable giving blood that has been found to be compatible by LISS tube IAT, even if it were found to be incompatible by gel IAT, provided that the people performing the tests are well practiced in the technique (i.e. currently, as opposed to historically, competent in pewrforming the technique).

Your Director should remember that, before the gel technique came about, almost all cross-matching was performed by the tube IAT (and earlier than that, we used saline, rather than LISS), and we did not kill every patient with an antibody!

We have recently had a couple of problem patients come up with a strong 1+ incompatible crossmatch units in gel using the Provue. A couple techs will do the crossmatch AHG via tube using LISS and get a compatible crossmatch. Our director is kind of ify about them using the tube to get compatible reactions when gel is clearly incompatible. Any suggestions on any other methods that can be used?

Gel is very sensitive to all sorts of "interferring" substances...colds, rouleaux, etc. 1+ is really not a strong reaction at all in gel on the Provue.

I agree with Malcolm...I would be comfortable transfusing appropriately proven tube-compatible blood. I might be a bit more comfortable using PEG as my enhancement media, however. LISS is a bit "old school" and not as sensitive as PEG.

I agree with everything stated so far, but wouldn't we want to do our antibody screening / id with LISS also?

I agree with everything stated so far, but wouldn't we want to do our antibody screening / id with LISS also?

Cathy,

Do you mean LISS in addition to PEG? Sorry, I didn't quite understand your question...

Sorry. What I mean is, before giving units crossmatched with LISS I would want to do the antibody screen (and id if necessary) with LISS. I would like to do the crossmatching in the same media used for antibody testing.

That sounds eminently sensible to me.