There is another current Thread regarding problems with the GEL Cards themselves. And I know there are other Threads regarding problems with false positive reactions from Surgiscreen (with the instrucions from Ortho to "keep them in the dark;" but now I am thinking perhaps WE are the ones being kept in the dark....

So another recent problem I have experienced are "additional"Antigens on the Donor Cells that cause positive reactions that you might not care about so much. Recently there were 2 Lot Numbers in a row with Lua. Now you wouldn't think that should cause a lot of problems, but we actually ended up having quite a few patients with anti-Lua!! Now we are having problems with the current Lot# of Ortho B Panel cells (VRB139); in particular, cell # 14. We have a few patients in whom we have identified anti-E, but then cell # 14 is also coming up strongly (2-3+). The first time I saw it, I thought perhaps it was the Jsa hanging out on the cell; that did not pan out. Upon calling Ortho, they said that Bg was on that cell. I'm not sure I am convinced that is what this is (I don't tend to see them that strong); but could be.

So, I did ask them to stop selecting donors with Lua (but meant Lows in general; yet Jsa now on panel). Again, I am a die-hard GEL fan, but these are annoying and time-consuming.

As they say on my favorite show, Extreme Home Makover: Are you with me?!!!

Brenda Hutson, CLS(ASCP)SBB

why would you not want Jsa on your panel? It is clinically significant . . . I have found a few of these in my lifetime (b4 we went to ISxm's - neg absc, 4+ xms at ahg). I actually purchase a panel that has a Jsa+ cell 3 out of 4 times and always a Kpa+ cell.

I agree with you Brenda about the Lu(a+) red cell being a nuisance, but I agree with you David about the Js(a+) cell being useful.

I think that anyone who produces a panel containing an strong positive Bg cell needs to be shot! ALmost half of the patients will be women who have been pregnant (almost I said) and a good number of those will have produced HLA antibodies. Goodness only knows how many positives will be because of the Bg+ cell.

:eek::eek:

why would you not want Jsa on your panel? It is clinically significant . . . I have found a few of these in my lifetime (b4 we went to ISxm's - neg absc, 4+ xms at ahg). I actually purchase a panel that has a Jsa+ cell 3 out of 4 times and always a Kpa+ cell.

Actually, I do agree with it being on a Panel (so I mis-stated my position; I was so caught up in my frustration with the other 2 issues that I erroneously dragged the Jsa into that same scenario). Yes, they are clinically significant and I too have identified them. But when you think about it, while Jsa is clinically significant, I don't know if I have ever seen it on the Screening Cells; so it is usually caught by chance while working up a patient with other antibodies; or by the patient showing signs of what turns out to be a positive DAT; whichever comes first.

Thanks for calling me on that; would not want to confuse anyone....

Brenda Hutson, CLS(ASCP)SBB

... Upon calling Ortho, they said that Bg was on that cell. I'm not sure I am convinced that is what this is (I don't tend to see them that strong); but could be. ...

Brenda Hutson, CLS(ASCP)SBB

Since we have started using Gel, we have lots more problems with Bg antibodies than we had with any tube technique. And with tube techniques, the reactions tended to be pretty weak. With Gel, in addition to seeing more Bg reactions, they tend to be quite a bit stronger than we experience with other techniques. One of the down sides of Gel.

Belva in Lincoln

Since we have started using Gel, we have lots more problems with Bg antibodies than we had with any tube technique. And with tube techniques, the reactions tended to be pretty weak. With Gel, in addition to seeing more Bg reactions, they tend to be quite a bit stronger than we experience with other techniques. One of the down sides of Gel.

Belva in Lincoln

Ah...not my experience, but thanks for the info.

Brenda

No method is perfect, and with a somewhat incomplete list of what antigens are where, it can be interesting, time consuming, and frustrating to match a pattern with a name whether it be Bga, Lua, or an antibody to a familial antigen.

We have had similar problems with the Bga+ cells on the Ortho Panel A. And it always seems to be on one of the cells that we use for the shortened panel on passive anti-D's from Rhogam.

We have had similar problems with the Bga+ cells on the Ortho Panel A. And it always seems to be on one of the cells that we use for the shortened panel on passive anti-D's from Rhogam.

One of our panel cells in the recent batch (NHSBT) was Mt(a+). It's caused mayhem, as many of our hospitals have found patients with ("naturally occurring") anti-Mta.

We are running out of Mt(a+) frozen red cells (and they are pretty manky anyway)!

:eek::eek:

We have had similar problems with the Bga+ cells on the Ortho Panel A. And it always seems to be on one of the cells that we use for the shortened panel on passive anti-D's from Rhogam.

Hmmm...we also use that limited panel for Passive D but do not have that problem???

Brenda Hutson