7.4
#265
EDUCATIONAL ASPECTS OF THE NEW ASHI PROFICIENCY TESTING PROGRAM ON ANTIBODY IDENTIFICATION AND CROSSMATCHING.
Marilyn Marrari and Rene J. Duquesnoy . Pittsburgh PA, University of Pittsburgh Medical Center, 15261, Division of Transplantation Pathology .
Our proficiency testing experience has demonstrated a considerable interlaboratory variability in the serum screening and crossmatch results (see Duquesnoy and Marrari, Arch. Pathol. Lab. Med.127:149-156, 2003). Often enough, survey results are not gradable because of low participant consensus. While new strategies and methodologies have become available, a lack of uniformity in test results will limit their efficient application in the clinical setting. Standardization of crossmatch and antibody screening methods is highly desirable. We have incorporated a strong educational component in the new ASHI survey program that began this year. A general goal of a serum screening is to determine what HLA antigens would be unacceptable. Comparisons between CDC, AHG, ELISA and FLOW methods show often that the results are technique-dependent. The new Website format of survey data entry permits each laboratory to enter any group of reactive class I and class II antigens. We will present informative examples how the analysis of these groups permits the identification of key antigens that react most frequently and can be used for performance grading. Other antigens reported with lower frequencies are ungraded but information about them is useful for educational purposes because participants can compare their own results with the overall data.We will also present examples of CDC, AHG and FLOW crossmatch results and how our analysis considers technique-dependent influences and HLA antigen acceptability determined by serum screens. The new AC survey is designed not only for determining laboratory proficiency but also represents an educational tool for participants to optimize their laboratory procedures and to increase performance standards in histocompatibility testing.