Immucor User Group Meeting Ft. Lauderdale, Florida May 12, 2016 - - PowerPoint PPT Presentation

Immucor User Group Meeting

• Ft. Lauderdale, Florida

May 12, 2016

Mary Sue Angiulli IRL/St. Lucie Medical Center Laboratory Supervisor

• Explain how an integrated hospital system

utilizes automation and solid phase technology by the means of the Immucor Echo Immunohematology analyzer in their Blood Banks

• Discuss troubleshooting of NTD, indeterminate

and “?” Reactions

Comprised of 13 Hospitals 3955 Beds

• Aventura Hospital & Medical Center

407

• Kendall Regional Medical Center

417

• JFK Medical Center

472

• JFK Medical Center – North Campus

245

• Lawnwood Regional Medical Center

365

• Mercy Hospital

488

• Northwest Medical Center

223

• Palms West Hospital

204

• Plantation General Hospital

264

• Raulerson Hospital

100

• St. Lucie Medical Center

229

• University Hospital and Medical Center

317

• Westside Regional Hospital

224

13 Hospitals with More than 58,000 Transfusions Annually

• Aventura Hospital & Medical Center

7273

• Kendall Regional Medical Center

8093

• JFK Medical Center

8750

• JFK Medical Center – North Campus

1042

• Lawnwood Regional Medical Center

6000

• Mercy Hospital

6500

• Northwest Medical Center

3755

• Palms West Hospital

2831

• Plantation General Hospital

1700

• Raulerson Hospital

1550

• St. Lucie Medical Center

2978

• University Hospital and Medical Center

3500

• Westside Regional Hospital

4646

• With greater volumes to manage with fewer

specialized Blood Bank technologists, we were looking to improve workflow efficiency

• Implemented to bring automation to our

Blood Banks

• Automated solid phase methodology offers

quality test results in a timely fashion

• Broad menu
• STAT priority capability
• Small footprint for space restrictions

• ABO/Rh
• Antibody Screen
• Antibody Identification
• Crossmatch on specimens with positive

antibody screen

• Some sites utilize Ready ID Extend I and II in

addition to the Ready ID

• Some sites utilize Panocell 20 liquid panel in

addition to the Ready ID panel

• Some sites using Echo for Cord Blood

workups, including DAT, unit retypes, dependent on workflow and staffing

• Echo – ABO/Rh, Antibody Screen
• Negative Antibody Screen
• Tube – Immediate Spin Crossmatch
• Positive Antibody Screen
• Echo – Ready ID Panel
• Tube – Select Cells from Panocell 20 to Rule Out
• Tube – Antigen Type Units and Patient
• Echo – Crossmatch
• NTD/Indeterminate
• Tube Antibody Screen, Panocell 20 with PeG and/or LISS

 Capture ID  Backup tube medium  AHG crossmatch  Any other special methods

Echo Positive Ab Screen Run Capture Ready ID Additional Cells required?

No Yes

Report Ab ID, Ag type Patient, Ag type Units, Full XM on Echo Run additional cells in PeG Tube Antibody ID’d

ABO/Rh

• Check reagents
• appearance, stir ball, bubbles, RT
• Check specimen
• centrifuged appropriately, RT
• Review reaction image
• Depending on analyzer access, the ? can be changed if

it appears that an artifact or minute cellular aggregate is interfering

• Repeat using hemagglutination tube method
• Recollect specimen
• Refer to reference laboratory

Antib ibody dy Sc Screen

• Check reagents
• appearance, stir ball, bubbles, RT
• Check specimen
• centrifuged appropriately, RT
• Review reaction image, compare image to the assay

cut-off table, access permitting - modify reaction if indicated

• Repeat on Echo
• Repeat using hemagglutination tube method
• Perform antibody ID on Echo using Ready ID panel

Antib ibody dy Ident ntific ificati ation

• n
• Check reagents – appearance, stir ball, bubbles
• Check specimen – centrifuged appropriately
• Review reaction image, compare image to the assay

cut-off table, access permitting - modify reaction if indicated

• Perform Ready ID Extend I and II
• Repeat using hemagglutination tube method with

PeG

• Repeat using hemagglutination tube method with

LISS

• Refer to reference laboratory

PeG Panel

Yes No

“SPD” Neg Screen with PeG Full XM Further Investigation Specific Antibody? Echo Positive Ab Screen Run Capture Ready ID and any required additional cells Specific Antibody?

Yes No

Report Ab ID, Ag type Patient, Ag type Units, Full XM on Echo PeG Screen

Pos Neg

Troubleshooting the Solid Phase Dependent (SPD) Antibody

• Workflow more efficient
• Reactions standardized, not subjective as

they are using tube method

• Interfacing reactions reduced opportunity for

clerical errors

• Automated procedure reduces risks of

inadvertently not performing procedure appropriately

• Bench technologists have more time to

devote to other tasks

• Method to electronically document QC review

in the Echo

• DAT that includes Complement
• Additional FDA approved Antigen Typing
• Remote viewing across markets/sites
• Ability to perform one antibody screen

without wasting the remainder of the Capture R Ready Screen 3 strip wells

• Two vampires walked into a bar and called for

the bartender. "I'll have a glass of blood," said one. "I'll have a glass of plasma," said the other. "Okay," replied the bartender, "That'll be one blood and one blood light.”