The CBBS Medical Technologists Committee is planning to devote a portion of an upcoming Regional Seminar to the topic of Automation in the Transfusion Service. There will be discussion of the pro's and con's of both the gel and solid phase antibody detection methods, and the difficulties in implementing automation. There will be two speakers who have implemented these methods in their own facilities. They would like to obtain additional input through the CBBS forum from other facilities that have tried these techniques. Does anyone have any information that could be shared?

To which the following replies were received:

1. I wanted to share with you the experience at University of Alabama (UAB) in Birmingham with the use of solid phase. I consulted with the Blood Bank Director to get this information. From the UAB experience these are the strengths and weaknesses of the solid phase.

Strengths of solid phase:
1. Increased sensitivity to alloantibodies (better that gel)
2. Does not pick up cold alloantibodies
3. The technique is fully automated and therefore decreases tech time.

Tests are run in batches.

Weakness of solid phase - Detects weak nonspecific alloantibodies and weak warm autoantibodies, which may then add tech time in trying to better define these antibodies.

2. Four of my facilities recently implemented gel - the manual system. The biggest issue in implementation has been "culture" - the sites that were doing tubes before loved gel and the institution that has been doing solid phase has been resistant (although many staff are "coming around). Gel has proven to be more sensitive than tube/LISS and less sensitive than solid phase. But the beauty of gel is the ease of training and since we are nearing the point of being able to use staff at all sites, the standardization of testing is invaluable. We will look at the Tecan if we can consolidate testing to one less site. Down the road, if we can centralize our serologies, a Tecan (or some sort of automation) will definitely be in the budget.

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Ira A. Shulman, MD
CBBS e-Network Forum Editor & Moderator