reagents/ methods in use by alqep transfusion medicine participants
Contents
1. Sample Used Serum Plasma Either Total Level A 2 6 22 71 7 23 3I Level B 35 32 53 48 22 20 110 Total 37 26 75 53 29 21 141 Antibody Screening of respondents Method SIDAT AIDAT LIDAT PIDAT Gel Gel SP man SP Total man auto auto Level A 0 0 4 13 12 39 10 32 2 6 3 10 0 3I Level B 18 16 6 5 13 12 41 37 29 26 I 1 1 2 2 III Total 18 13 6 4 17 12 53 37 39 27 3 2 4 3 2 1 142 Antibody Screening of respondents of Screening Cells 2 3 Total Level A 11 35 20 65 3I Level B 19 17 91 83 110 Total 30 21 111 79 141 Antibody Screening of respondents Screening Cells Source DBL Gamma Immucor Ortho Total Level A 11 35 0 6 19 14 45 3I Level B 41 40 I 1 14 14 47 46 103 Total 52 39 1 20 15 61 46 134 Page 6 of 14 Alberta Laboratory Quality Enhancement Program CPSA October 2005 Copyright 2005 College of Physicians and Surgeons of Alberta REAGENTS METHODS IN USE BY ALQEP TRANSFUSION MEDICINE PARTICIPANTS Antibody Screening Tube methods of respondents Readings at IS RT 37 IAT Macro IAT Micro Level A 5 31 0 2 13 11 69 7 44 Level B 50 64 7 9 43 55 53 68 63 81 Total 55 59 7 72. Method Sal IS SIDAT AIDAT LIDAT PIDAT Gelman Electronic Total Level A 14 47 0 0 I 3 0 I 3 14 47 30 Level B 24 22 17 15 6 5 12 11 27 24 18 16 7 6 IHI Total 38 27 17 12 6 4 13 9 27 19 19 14 21 15 141 Page 8 of 14 Alberta Laboratory Quality Enhancement Program CPSA October 2005 Copyright 2005 College of Physicians and Surgeons of Alberta REAGENTS METHODS IN USE BY ALQEP TRANSFUSION MEDICINE PARTICIPANTS Confirmation of Donor ABO and Rh Typings 79 of respondents perform confirmatory ABO and D typing on all donor units received 2 retype all type O units and 6 confirm O Rh negative units Confirmation Performed of respondents All units AlltypeO All O Rh Neg Level A 26 87 0 I 3 Level B 85 77 3 3 8 7 Total 11 79 3 2 9 6 Postnatal Testing 82 of respondents perform postnatal testing with 26 of those testing all deliveries and 73 testing only cases where the mother s Rh type is negative or unknown Testing protocols vary widely among respondents Postnatal Testing of respondents Performed Yes No Total Level A 26 84 5 16 31 Level B 91 82 20 18 III Total 117 82 25 18 142 Postnatal Testing of respondents performing postnatal testing Criteria All deliveries Moms Rh Neg or Only on req
3. Reagent source Ortho DBL Gamma Immucor Total Level A 7 23 21 68 3 2 6 31 Level B 27 25 73 67 I 1 8 7 109 Total 34 24 94 67 2 1 10 7 140 Rh Control of respondents Criteria Never All Group AB AB Rh WeakD Is testing Total Level A 0 15 48 10 32 5 16 0 3 31 Level B 16 15 69 63 17 16 4 4 3 3 0 109 Total 16 11 84 60 27 19 9 6 3 2 I 1 140 Rh Control of respondent using an Rh control Reagent Comm 22 6 8 5 3 Alb Auto Iner Sal Gel Total type Alb Alb Alb Alb t AB Level A 12 39 2 6 5 16 1 3 I 3 0 7 23 1 3 1 3 I Q 31 Level B 54 58 3 3 9 10 2 2 0 I 1 23 25 0 0 I 1 93 Total 66 53 5 4 14 11 3 2 1 1 EG 30 24 1 1 1 1 2 Q 124 Confirmation of Patient ABO and Rh Typings 63 of respondents indicate that they perform confirmatory ABO and Rh testing on patient samples 2 perform ABO confirmation only and 2 perform Rh confirmation only Of those performing confirmation 72 confirm the typing on all samples and 28 perform the testing if there is no historical typing on file Confirmation Performed of respondents ABO amp Rh ABO Only Rh only Total respondents Level A 21 68 0 0 3l Level B 69 62 3 3 3 3 II Total 90 63 3 2 3 2 142 ABO amp Rh Confirmation
4. rabbit mono rabbit mono Level A 2 9 2 9 8 36 10 45 22 Level B 15 16 25 27 18 19 35 38 93 Total 17 15 27 23 26 23 45 39 115 Antiglobulin Sera of respondents Reagent Source DBL Gamma Immucor Ortho Total Level A 13 50 0 4 12 46 26 Level B 62 65 I 1 6 6 27 28 96 Total 75 61 I 1 7 6 39 32 122 Antibody Identification The majority of respondents 65 required antibody identification of each positive antibody screen regardless of circumstances However a number of laboratories only require repeat antibody identification at defined intervals or if a change in antibody reactivity or patient history is noted Repeat antibody identification on positive antibody screen of respondents Frequency Each Repeat every Change in If possibly specimen 3 7 days 14 30 3 6 reactivity stimulated days days days months months Level A 14 45 5 1 3 3 10 1 3 0 0 10 32 3 10 16 Level B 79 71 4 4 2 2 2 2 0 2 2 I 1 15 14 17 15 Total 93 65 9 6 3 2 5 4 I I 2 1 I 1 25 18 20 14 Compatibility Testing The majority of respondents 85 perform a serologic crossmatch with 27 utilizing a saline immediate spin method 15 of respondents routinely perform an electronic crossmatch with 47 of Level A facilities choosing this method Crossmatch of respondents
5. Copyright 2005 College of Physicians and Surgeons of Alberta REAGENTS METHODS IN USE BY ALQEP TRANSFUSION MEDICINE PARTICIPANTS Standards state that the use of an antiglobulin reagent that contains only anti IgG is acceptable and the use of a polyspecific reagent containing anti complement has been shown to be unnecessary in pretransfusion testing 5 While the use of a polyspecific reagent by a number of laboratories does not pose a risk to patient safety it may result in unnecessary antibody investigation Antibody Investigation Although the majority of participants continue to perform antibody identification on each sample with a positive antibody screen a significant number of laboratories have streamlined their processes to include re identification of known antibodies under defined criteria While re identification of known antibodies rarely serves a significant purpose methods of testing must detect any additional clinically significant antibodies Compatibility Testing Most Level A facilities perform compatibility testing between patient and donor by either immediate spin crossmatch 49 or electronic crossmatch 47 The majority of Level B 85 continue to perform a serologic crossmatch with 44 performing an antiglobulin method This may indicate that the resources required for serologic crossmatch in a high volume facility are significant and better directed to other activities whereas smaller laboratories do not possess
6. 45 48 64 68 70 74 Antibody Screening Tube methods of respondents IAT Washing Cell washer Manual Level A 16 100 0 Level B 37 49 38 51 Total 53 58 38 42 Antibody Screening Tube methods of respondents PIDAT Incubation Time 10 min 15 min Level A 7 58 5 42 Level B 27 66 14 34 Total 34 64 19 36 Antibody Screening Tube methods of respondents LIDAT Incubation Time 10min 15 min 20 min 30 min Level A 3 75 25 0 0 Level B 4 31 7 54 8 8 Total 7 41 8 47 6 6 Antibody Screening Tube methods of respondents SIDAT Incubation Time 15 min 30 min 40 min Level A 0 0 0 Level B 10 56 7 39 6 Total 10 56 7 39 6 Antibody Screening Tube methods of respondents AIDAT Incubation Time 15 min 30 min Level A 0 0 Level B 2 33 4 67 Total 2 33 4 67 Antibody Screening of respondents Controls included Auto DAT Level A 8 26 3 10 Level B 66 59 33 30 Total 74 52 36 25 Page 7 of 14 Alberta Laboratory Quality Enhancement Program Copyright 2005 College of Physicians and Surgeons of Alberta CPSA October 2005 REAGENTS METHODS IN USE BY ALQEP TRANSFUSION MEDICINE PARTICIPANTS Antiglobulin Sera of respondents Reagent Type Polyspecific Polyspecific IgG IgG Total
7. Always Group O Donors Babies Discrepancies Other Level A 3 10 0 13 42 5 16 4 13 3 Level B 48 43 6 5 5 5 6 5 4 4 3 3 Total 51 36 6 4 18 13 11 8 8 6 4 3 ABO Reverse Typing of respondents Method IS RT Gel Man Gel Auto Total Level A 26 84 3 10 3 3 31 Level B 81 76 19 18 7 7 0 107 Total 107 78 22 16 8 6 I 1 138 Page 3 of 14 Alberta Laboratory Quality Enhancement Program CPSA October 2005 REAGENTS METHODS IN USE BY ALQEP TRANSFUSION MEDICINE PARTICIPANTS ABO Reverse Typing of respondents Reagent Source DBL Gamma Immucor Ortho Total Level A 20 65 0 5 16 6 19 31 Level B 50 48 2 2 15 14 38 36 105 Total 70 51 2 1 20 15 44 32 136 ABO Reverse Typing Additional Cells of respondents Cells used A2 O Auto Level A 3 10 3 10 5 16 Level B 2 2 11 10 13 12 Total 5 4 14 10 18 13 Rh D Typing 80 of respondents perform Rh D typing by a saline tube immediate spin method and 7 use gel technology 9 of respondents indicate that they include a room temperature incubation prior to reading the D typing and 5 of responses indicate methods that are not consistent with accepted routine D typing practice i e sal 37 alb 37 SIDAT 60 of respondents indicate that they utilize monoclonal IgM IgG reagents for D typing 23 use monoclonal IgM reagents and 14
8. of respondents performing confirmation Criteria Always No historical group Level A 8 38 13 62 Level B 60 82 13 18 Total 68 72 26 28 Page 5 of 14 Alberta Laboratory Quality Enhancement Program Copyright 2005 College of Physicians and Surgeons of Alberta CPSA October 2005 REAGENTS METHODS IN USE BY ALQEP TRANSFUSION MEDICINE PARTICIPANTS Antibody Screening A wide variety of antibody screening protocols are followed by participants The majority of facilities utilize the PEG indirect antiglobulin test 37 or gel technology 29 79 perform a 3 cell screen and 21 use 2 cells only Of those participants performing a tube test method 100 read the test after indirect antiglobulin test with 68 performing a macroscopic reading and 74 a microscopic reading 66 read the test after immediate spin or room temperature incubation and 48 read after 37 C incubation Incubation times for the antibody screen vary 56 of Level B participants using SIDAT method incubate the test for only 5minutes which may not represent best practice see Discussion 52 of respondents include an auto control with the antibody screen and 25 routinely perform a DAT in conjunction with an antibody screen 62 of facilities utilize an antiglobulin sera that contains anti IgG only whereas 38 use a polyspecific reagent Antibody Screening of respondents
9. ALQEP ALBERTA LABORATORY QUALITY ENHANCEMENT PROGRAM College of Physicians and Surgeons of Alberta REAGENTS METHODS IN USE BY ALQEP TRANSFUSION MEDICINE PARTICIPANTS An Educational Supplement prepared by ALQEP October 2005 Alberta Laboratory Quality Enhancement Program The Transfusion Medicine TM Program of the Alberta Laboratory Quality Enhancement Program ALQEP provides mandated transfusion medicine proficiency testing for all laboratories performing TM test procedures in Alberta British Columbia Manitoba and Saskatchewan As well a number of laboratories in the Northwest Territories Ontario and the Yukon Territory voluntarily participate in the program Transfusion Medicine Profiles The ALQEP TM Program requests that participants complete a detailed profile upon registration The profile is stored electronically by ALQEP and a copy is distributed to participants biannually with a request to enter and submit any changes that have occurred in the laboratory test methods or reagents The last profile update request occurred in the fall of 2004 Data from the profiles on file at ALQEP has been tabulated and is presented in this paper Any additional changes to the profiles submitted by participants since the 2004 update have been incorporated Participant Demographics ALQEP Transfusion Medicine Participants Province Level A Level B Total Alberta II 2l 32 British Columbia 16 55 71 Manit
10. CINE PARTICIPANTS Conclusion The responses to the Transfusion Medicine profiles indicate that while laboratory practices may vary widely the majority of participants have methods and reagents in place that allow for acceptable testing results This represents appropriate patient care and safety A small number of laboratories should review testing processes and procedures The use of an appropriate Rh control test and acceptable antibody screen incubation times are necessary to ensure accurate test results Although the inclusion of various other aspects of testing does not introduce any direct patient risk the resources required to perform these tests or to investigate discrepant findings could be better directed to other processes that may benefit patient outcome Also the investigation of clinically insignificant discrepant results not only places additional strain on resources but may delay transfusion The ALQEP Transfusion Medicine Program distributes participant profiles for biannual revision and will report on any significant changes in laboratory practice following the next update Page 13 of 14 Alberta Laboratory Quality Enhancement Program CPSA October 2005 Copyright 2005 College of Physicians and Surgeons of Alberta REAGENTS METHODS IN USE BY ALQEP TRANSFUSION MEDICINE PARTICIPANTS References I Judd WJ Modern approaches to pretransfusion testing Immunohematology 1999 15 41 52 2 Moore BPL Humphreys P Lovett
11. Moseley CA Serological and immunological methods 7 ed Toronto ON Canadian Red Cross Society 1972 3 Brecher ME ed Technical manual 14th ed Bethesda MD American Association of Blood Banks 2002 4 Gamma Biologicals Houston TX Package insert anti D monoclonal polyclonal blend Gamma clone 1996 5 Dominion Biologicals Limited Dartmouth NS Canada Package insert anti D monoclonal polyclonal blend Novaclone 1996 6 Gamma Biologicals Houston TX Package insert anti D monoclonal blend Gamma clone 2000 7 Padget BJ Hannon JL Discrepancies in Rh D typing of sensitized red blood cells using monoclonal polyclonal anti D reagents case report and review Immunohematology 2001 17 10 13 8 Standards for hospital transfusion services Version Ottawa ON Canadian Society for Transfusion Medicine 2004 9 Z902 04 Blood and blood components Mississauga ON Canadian Standards Association 2004 10 Issitt PD Antibody screening elimination of another piece of the test Transfusion 1999 39 229 230 I1 Judd WJ Steiner EA Oberman HA Nance SJ Can the reading for serologic reactivity following 37 C incubation be omitted Transfusion 1992 32 304 308 12 Judd WJ Fullen DR Steiner EA Davenport RD Knafl PC Revisiting the issue can the reading for serologic reactivity following 37 C incubation be omitted Transfusion 1999 39 295 299 13 Judd WJ Butch SH Oberman HA Steiner EA Bauer RC The evaluation of
12. a positive direct AHG test in pretransfusion testing Transfusion 980 20 17 23 14 Judd WJ Barnes BA Steiner EA Oberman HA Averill DB Butch SH The evaluation of a positive direct AHG test in pretransfusion testing revisited Transfusion 986 26 220 4 15 Beck ML Marsh WL Complement and the antiglobulin test Transfusion 1977 17 529 16 Standards for blood banks and transfusion services 237d ed Bethesda MD AABB 2005 Page 14 of 14 Alberta Laboratory Quality Enhancement Program CPSA October 2005 Copyright 2005 College of Physicians and Surgeons of Alberta
13. about the D testing performed in their laboratory Laboratories should determine the characteristics of the reagent in use and manufacturer s instructions must be followed for all testing The use of an appropriate Rh control is required to ensure that false positive reactions are not occurring due to immunoglobulin coating of red cells or serum factors that induce rouleaux 3 In the past a manufacturer s control was supplied with slide and tube reagents However the advent of monoclonal anti D reagents has changed the required Rh typing practice The diluents for these reagents may contain from 3 to 8 bovine serum albumin and they are regarded as low protein anti D Therefore the routine use of an Rh control is not required with monoclonal Rh D typing reagents 456 However as red cells heavily coated with immunoglobulin may give unreliable results and spontaneous agglutination may occur in any saline reactive test in the presence of cold autoagglutinins or rouleaux a concurrent control must be performed for red cell specimens that demonstrate positive reactions in all ABO forward grouping and Rh typing tests i e group AB D positive 37 The recommended control reagent is a manufacturer s control autologous serum or 6 8 bovine serum albumin 3 Confirmation of Patient ABO and Rh D Typings Confirmation of patient ABO typing is only required by standards if an electronic computer assisted crossmatch is performed Although only 15 of f
14. acilities utilize an electronic crossmatch 65 of laboratories choose to perform ABO confirmation on patient samples 65 of facilities also confirm the patient D type Antibody Screening Transfusion medicine standards require that antibody screening shall include a 37 C incubation followed by an indirect antiglobulin procedure that has been shown to have good sensitivity for the detection of clinically significant antibodies or an alternative test method with appropriate documentation of sensitivity Although all facilities use test methods that are acceptable a number of Level B laboratories incubate SIDAT antibody screens for only 15 minutes It is generally recommended that 30 to 60 minute incubation is necessary for saline based tests and these facilities should consider increasing the incubation time or changing to a method that includes an enhancement media Although it has been shown that the omission of reading of antibody screens at immediate spin phase after 37 C incubation and microscopically does not result in significant patient risk 3 0 2 a number of laboratories most notably Level B facilities continue these practices As well 52 of participants include an auto control with antibody screening and 25 routinely perform a direct antiglobulin test with pretransfusion testing These tests are believed to be of limited clinical value 3 3 4 Page 11 of 14 Alberta Laboratory Quality Enhancement Program CPSA October 2005
15. at they utilize monoclonal reagents for ABO typing and 3 state they use monoclonal polyclonal blend reagents 36 of responding laboratories routinely include anti A B as part of the ABO typing While only 10 of Level A facilities include this test with all ABO typings 43 of Level B laboratories do so 4 of facilities use anti A B for group O samples only 13 use the reagent for donor ABO confirmation testing and 17 utilize the reagent under other special circumstances 4 of respondents routinely include A cells with the ABO reverse typing 10 include O cells and 13 perform an auto control in conjunction with the ABO typing ABO Forward Typing of respondents Copyright 2005 College of Physicians and Surgeons of Alberta Method IS RT Gel man Gel auto Total Level A 26 84 3 10 3 3 31 Level B 87 79 16 15 7 6 0 110 Total 113 80 19 13 8 6 I 1 141 ABO Forward Typing of respondents Reagent Type Mono Mono Poly Total Level A 31 100 0 3l Level B 104 96 4 4 108 Total 135 97 4 3 139 ABO Forward Typing of respondents Reagent Source DBL Immucor Ortho Total Level A 23 74 0 8 26 31 Level B 83 75 3 3 24 22 110 Total 106 75 3 2 32 23 141 ABO Forward Typing Use of Anti A B of respondents Criteria
16. oba 2 6 8 Ontario l 0 l Saskatchewan 4 30 34 Northwest Territories 0 3 3 Yukon Territory 0 Total 34 116 150 Level A facilities facilities that perform ABO amp Rh D typing antibody screen crossmatch if performed at facility and complex serologic investigation including the routine availability of at least 22 in date panel cells antigen typing as required and specialized investigation techniques Level B facilities facilities that perform ABO amp Rh D typing antibody screen and crossmatch if performed at facility may perform basic serologic investigation including the routine availability of less than 22 in date panel cells and possible antigen typing Copyright 2005 College of Physicians and Surgeons of Alberta REAGENTS METHODS IN USE BY ALQEP TRANSFUSION MEDICINE PARTICIPANTS Participant Profiles Received of total participants Province Level A Level B Total Alberta 11 100 21 100 32 100 British Columbia 13 81 50 91 63 89 Manitoba 2 100 6 100 8 100 Ontario 1 100 na 1 100 Saskatchewan 4 100 30 100 34 100 Northwest Territories na 3 100 3 100 Yukon na 1 100 100 Total 31 91 111 96 142 95 Abbreviations The following abbreviations are used in the paper Ab scr antibody screen AIDAT albumin indirect antiglob
17. st Misys 3 10 8 7 11 8 Triple G 3 14 13 15 11 In house developed 2 6 I 1 3 2 System source not identified 2 6 17 15 19 13 None 3 44 40 45 32 Total 3I III 142 Transfusion Medicine Information Systems of respondents System Level A Level B Total Part of LIS 26 84 31 28 57 40 In house developed 3 I 1 2 I Lifeline 3 0 1 Hemocare 2 6 0 2 1 None 3 79 71 80 56 Total 3I III 142 Page 10 of 14 Copyright 2005 College of Physicians and Surgeons of Alberta Alberta Laboratory Quality Enhancement Program CPSA October 2005 REAGENTS METHODS IN USE BY ALQEP TRANSFUSION MEDICINE PARTICIPANTS Discussion ABO Typing Traditionally anti A B was considered a necessary part of ABO forward typing as it was more effective than human anti A or anti B in detecting weakly expressed ABO antigens 2 3 However the use of monoclonal antibodies for the production of anti A and anti B has eliminated the necessity for the routine use of anti A B The inclusion of A2 O or autologous cells with an ABO typing may be useful in investigation of discrepant results but is considered to be of limited value in routine testing 3 Rh D Typing The majority of respondents utilize appropriate methods reagents and controls for Rh D typing However the profile responses indicate that a small number of facilities are not following accepted D typing practice or are confused
18. state that they use monoclonal polyclonal blend reagents Slide and tube reagents are listed by 3 60 of responding facilities include an Rh control in conjunction with all D typing and 25 perform a control on all type AB or AB D positive samples 2 perform an Rh control only with weak D testing 1 only on first testing and 11 of respondents state that they never perform an Rh control Of those laboratories performing an Rh control 53 use a commercially supplied reagent 2 use a gel control 4 use 22 albumin 1 use 6 8 albumin and 24 use autologous serum or plasma 6 use other reagents Rh D Typing of respondents Method IS RT Sal 37 Alb 37 Gelman Gel auto SIDAT Total Level A 28 90 3 0 0 3 I 3 0 31 Level B 84 77 II 10 4 4 I 1 7 6 0 2 2 109 Total 112 80 12 9 4 3 1 8 6 I 1 2 1 140 Rh D Typing of respondents Reagent type Mono IgM Mono IgM IigG Mono poly S amp T Total Level A 6 19 21 68 2 6 2 6 31 Level B 26 24 63 58 18 17 2 2 109 Total 32 23 84 60 20 14 4 3 140 Page 4 of 14 Alberta Laboratory Quality Enhancement Program CPSA October 2005 Copyright 2005 College of Physicians and Surgeons of Alberta REAGENTS METHODS IN USE BY ALQEP TRANSFUSION MEDICINE PARTICIPANTS Rh D Typing of respondents
19. the required technology or feel that the additional confidence derived from a serologic crossmatch is of benefit Confirmation of Donor ABO and Rh Typings Canadian transfusion medicine standards only require that the transfusion service confirm the ABO type of donor red cells if a serologic crossmatch is not to be performed AABB standards require ABO confirmation of all donor units and Rh confirmation of all Rh negative units The majority of respondents have chosen to perform this testing Postnatal testing There is a wide variation of testing protocols used by those laboratories performing postnatal testing with acceptable practice represented in most areas However only 57 of respondents state that they perform or order fetal bleed detection tests when indicated by the mother and cord Rh types This test is required by standards and has significant impact on patient care Laboratories should review their protocols to ensure that appropriate processes are in place Information Systems While the majority 97 of Level A facilities have a Laboratory Information System and a Transfusion Medicine Information System a significant number of Level B laboratories 40 LIS 71 TM information system do not have access to these technologies Page 12 of 14 Alberta Laboratory Quality Enhancement Program CPSA October 2005 Copyright 2005 College of Physicians and Surgeons of Alberta REAGENTS METHODS IN USE BY ALQEP TRANSFUSION MEDI
20. uest unknown Level A 6 23 20 77 0 Level B 24 26 66 73 I 1 Total 30 26 86 73 I 1 Postnatal Testing of respondents performing postnatal testing Tests ABO Rh Rh ABO Rh Rh Ab scr DAT Fetal cell performed mom mom cord cord mom cord screen refer Level A 14 54 4 24 92 4 14 54 23 88 22 85 Level B 55 60 2 2 87 96 4 4 40 44 81 89 45 49 Total 69 59 3 3 111 95 5 4 54 46 104 89 67 57 Page 9 of 14 Alberta Laboratory Quality Enhancement Program Copyright 2005 College of Physicians and Surgeons of Alberta CPSA October 2005 REAGENTS METHODS IN USE BY ALQEP TRANSFUSION MEDICINE PARTICIPANTS Information Systems 68 of respondents indicate that a LIS is in place in the laboratory Only one Level A facility does not have a LIS whereas 40 of Level B facilities do not have this technology 56 of respondents do not have a Transfusion Medicine Information system Laboratory Information Systems of respondents System Level A Level B Total CCD 0 1 I 1 Cerner 4 13 0 4 3 Eclipsis I 3 0 I 1 HealthVision 3 10 0 3 2 Labview 0 1 1 Mak Progesa 2 6 0 2 I Medisolution 0 5 5 5 4 Meditech 10 32 17 15 27 19 Northern Software 0 2 2 2 I RSA Roses 0 I 1 I 1 SCC 3 0 I 1 Soft Lab 3 0 1 Sunque
21. ulin test Alb albumin Alb 37 albumin 37 C ALQEP Alberta Laboratory Quality Enhancement Program Comm commercial Rh control reagent DAT direct antiglobulin test DBL Dominion Biologicals Limited Gel auto gel technology automated procedure Gel man gel technology manual procedure IAT indirect antiglobulin test IS immediate spin LIDAT low ionic strength saline LISS indirect antiglobulin test LIS laboratory information system Macro macroscopic Micro microscopic Min minutes Mono monoclonal Neg negative PEG polyethylene glycol PIDAT polyethylene glycol indirect antiglobulin test Poly polyclonal RT room temperature S amp T slide and tube Sal saline Sal 37 saline 37 C SIDAT saline indirect antiglobulin test SP auto solid phase technology automated procedure SP man solid phase technology manual procedure Transfusion Medicine Page 2 of 14 Alberta Laboratory Quality Enhancement Program Copyright 2005 College of Physicians and Surgeons of Alberta CPSA October 2005 REAGENTS METHODS IN USE BY ALQEP TRANSFUSION MEDICINE PARTICIPANTS ABO Typing 93 of respondents perform ABO typing by a saline tube method with the majority of these reading after immediate spin 7 use gel technology for ABO typing 13 of the laboratories using a tube method indicated that they include a room temperature incubation prior to reading the ABO forward typing and 16 read the reverse typing after RT incubation 97 of respondents indicate th
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