Mary,

We have gone down this path already (about two years ago).  I can offer the
solution that I came up with and has proved very effective and "nearly"
flawless.  It allows for the necessary preservation of tissues that are
either non-reactive to certain antibodies (eg. WT-1, TTF-1, E-cadherin, ER
and PR; ie. these are the ones we have been unable to work up on Prefer
fixed tissues) while enjoying the vastly superior results on the
overwhelming number of antibodies done on the Prefer fixed tissues.  In
addition it keeps the more pleasant working environment with Prefer as the
dominant fixative.  I have included a portion of my "Histology Specimen
Handling" policy at the end of my e-mail.  Of particular interest to you
will be the "Fixation" and the "Labeling Cassettes and Slides" sections.

I urge you to give me a call and I can give you some more details on
answering your pathologists concerns and in steps of implementation after I
get a clear picture of your operational circumstances.  It obviously
wouldn't work in every situation but might be a good fit for you or at least
a trial for feasibility.

Greg Luck
Anatomic Pathology Supervisor
Deaconess Medical Center
800 W. 5th Ave
Spokane, WA 99204
Phone 509.473.7077
Fax 509.473.7133
luckg@empirehealth.org     

 	Fixation:
 
          a)   Specimens are "routinely" fixed in Prefer.  Fixative should
be
               added as soon as possible; exceptions being specimens which
are
               submitted for frozen section, or for immediate exam and
               consultation or at the request of the grossing pathologist.
 
          b)   All breast specimens and some selected tissue block cassettes
               are fixed in 10% N.B.F. (eg. neoplasms of the ovary, lung and
               lymphomas) as directed by the grossing pathologist.
 
     Labeling Cassettes:
 
	    a)   Green cassettes and slides are prepared for routine
surgical 
               specimens fixed in Prefer and yellow cassettes and slides for
those fixed in            
		   10% N.B.F.
      
          b)   White cassettes are prepared for cytology specimens and bone
               marrows.
          
          c)   Blue cassettes are prepared for autopsy specimens.



-----Original Message-----
From: Mary Bryhan [mailto:mbryhan@NORTHERNHEALTH.ORG]
Sent: Wednesday, May 19, 2004 8:22 AM
To: histonet@pathology.swmed.edu
Subject: [Histonet] Alternative fixative users (Prefer)


Hi,  after many years as a Prefer fixative user our pathologists are telling
us that we have to go back to formalin.  This came about after a letter to
the editor appeared in the Journal of Surgical Pathology.  

Has anyone out there been approached by their pathologists to switch back?

Mary Bryhan


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