Validity of the antibody screen when using lipemic samples

A colleague wonders about the validity of antibody screening results when using lipemic samples. Specifically, the colleague asks if hyperlipidemia an interfering factor when antibody screening using either the Galileo, the Echo, or the upcoming Neo; could increased plasma lipids interfer with the antibody/antigen reactions or just be a visual problem in viewing reactions? Would using an ultracentrifuge to obtain a clearer specimen be an acceptable alternative or could any unexpected alloantibodies be "centrifuged out" of the serum/plasma sample? Apparently, upon installation of the equipment, laboratory staff were left with the impression that lipemic samples should not be used. Reportedly, the equipment operator's manual or package insert states that hemolyzed samples 3+ or greater, and icteric / lipemic samples should not be used. There are no qualifiers for the degree of icteris or lipemia such as "gross" or "4 +" etc. The hospital wrote in their procedures that for lipemic or icteric samples, a tube method for antibody screens should be used. Is that an appropriate practice?

The following comments were received.

The following response was provided by a colleague who works at Immucor : "Hyperlipidemia is not a problem in the Capture-R RS assays. The plasma lipids are washed away prior to addition of Capture-P Ready Indicator Cells, so the lipids cannot interfere in the reading of test results Sample hemolysis and lipemia only pose a problem in hemagglutination reactions - they mask the RBCs and may prevent accurate automated interpretation."

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