Technical Tips Tips on using the ArtisanLink Special Staining System Jamie Nowacek, BS, HT(ASCP) CM, QIHC, PMP Dako North America, Inc. Carpinteria, CA, USA ArtisanLink Staining System is an automated special stains slide processor that can be used as a stand-alone system or operated in a networked configuration using a local area network (LAN) or a Laboratory Information System (LIS). The system uses special stains kits and accessory reagents packaged in patented cartridges that provide precision dispensing of reagents for optimal staining quality. ArtisanLink utilizes a patented reaction chamber and can handle multiple tasks in a laboratory in a single run. With a broad menu of special stains, the system can optimize laboratory workflow through automation dramatically improving productivity. This article provides tips on hardware and software usage as well as some recommendations regarding the use of slides and reagents to get the most out of the ArtisanLink Staining System 1. of each session, a waste valve rinse should be performed to prevent contamination of the tubing and bottles. The user should inspect the inner orange waste gasket when replacing the cap to check that this has not been torn or ripped 2 (Fig.1). Hardware Tips The following is a four-point inspection to keep ArtisanLink running smoothly: Waste management: The ArtisanLink Staining System utilizes a decrement system to track waste accumulation and capacity requirements. A special aspiration system allows the instrument to separate waste into four categories: metals, alcohol, combined dyes and water solubles. Depending on the laboratory workload volume, 2 L or 4 L bottles can be configured in the software. Upon completion 1 This article provides tips for experienced users. 2 A torn or ripped orange waste gasket may be the result of excessive torque applied when screwing/unscrewing the cap. Figure 1. Waste bottle showing the orange waste gasket. 222 Connection 2010
Keeping software and bottle inventory evenly matched at all times will prevent overflow and consequential aborted runs. Each time a bottle is removed, perform the Rinse valves (Fig. 2) from the ArtisanLink bulk fluid screen to enable optimal aspiration. Bulk fluid maintenance: Bulk liquids consist of liquids used in a staining run for rinsing or diluting. Dako Wash Solution, 100% ethanol and 95% ethanol, is required for use on the ArtisanLink Staining System. Dako Wash Solution requires diluting and mixing prior to use. For bulk fluid maintenance, rotate the six bulk positions with adjacent bottles. When the alcohol bottle is rotated through each valve position routinely, it reduces the overall manual maintenance that will be needed outside slide sessions. Always unsnap the bottle tubing from the valve before unscrewing the cap to alleviate torque and pressure on the tubing connectors. When the caps are off, inspect the black o-ring inside the cap and return the cap with the notch to align and secure the cap tightly (Fig. 3). This will provide an even pressure and remove waste fluid during staining. Be sure to match software to bottle inventory. After reloading the bottle, prime three or more times to return the fluid into the tubes or lines. Figure 2. Fluid screen showing how to access the Rinse valves button referring specifically to waste valves. Connection 2010 223
Figure 3. The inside of a bulk bottle cap showing the black o-ring. The red circle denotes the groove that should be aligned to the bottle neck notch. Reagent handling: At the end of each staining session, it is recommended to remove all reagent packs from the reagent carousel. Removing hazardous chemicals routinely will help maintain the life of the instrument. Slide platform maintenance: To ensure proper contact between the slides and the slide heater plates, the user should wipe the back of each slide with a dry gauze pad before placing it on the slide carousel. This will not only ensure a good slide clip seal, but will also optimize heating performance. Likewise, wiping residue from the slide platform upon removal of the slide and clip will prevent chemical erosion. For the same reasons, it is also recommended to regularly clean the spill tray and drip ring. Software Tips The DakoLink software allows review of workload information based on customized settings. Additionally, the software can track information previously tracked manually by the histotechnologist. It can measure and separate waste, track fluid inventory, maintain history of fluid lot numbers and expirations, provide customized audio alerts, perform automatic maintenance and, most importantly, identify slides. The making the hardware and software work together along with other parameters such as using the right slides, reagents/reagent packs and chemistry is the first step toward mastering the automated staining process. handheld 2D barcode scanner can retrieve information about slides and reagents utilized during any given session. The reports generated can be exported while the stainer is still in use. Upon installation, the following suggestions may be helpful in maximizing the use of the DakoLink software: Customize user privileges allowing login access to inventory, report fields, system settings and procedure customizations. These are found under Administration/Configuration/USERS and GROUPS (Fig. 5). The ArtisanLink software is part of the DakoLink software family. 224 Connection 2010
Set SYSTEM SETTINGS to Automatically perform waste valve rinse after runs and Require confirmation before run begins. This will automatically start the run and perform routine maintenance (Fig. 4). Customize the NEW SLIDES tab to fit the patient information that is pertinent to your Quality Control (QC) program. Slide accessioning will be easier, and a simple 2D scan of the slide label (see Fig. 6) will yield valuable information. Set up slide labels to print customizable text. Maximize the text by utilizing Slide notes as a field option or placing Hospital institution as Case fields. Customizing slide labels using the Case fields option will ease slide accessioning and ultimately save time in the QC process that follows. Populate the bulk fluid lot numbers in the fluid inventory screen to ensure QC history reports are easily obtained upon demand. The assignment of bulk liquids automatically sets a 30-day reminder to rotate the fluids. The fluids are shown in red font when they have exceeded the 30-day reminder. Tips on Slides and Reagents Slides The type of glass slide used and how it is clipped into position can affect the staining procedure. Some tips to ensure a consistent staining result are: Avoid using slides with etched or painted surfaces. The uneven surface can prevent a consistent horizontal spreading of the fluid during sessions. Only use chemically resistant slide labels, e.g., Dako s S3393 (DL213), 0.75 x 0.75 mm labels. Larger labels will prevent the gasket from sealing tightly and as a consequence may leak fluid during the staining session. Slides, whether charged or uncharged, can be used for automation UNLESS mirroring occurs (see Reference). In this case, lowering the heat exposure to the slide or switching from ionically-coated slides to uncharged slides will reduce the phenomenon. While an instrument is staining, the user can set up the next session. Retrieve live updates on the reagent inventory utilizing the ADMINISTRATION report features. Multitasking by pulling out colder reagents needed for the next run can save valuable setup time. Use clean slides: Wipe the back of the slide before placing it into position. This will not only ensure a good slide clip seal, but will also optimize heating performance. Make sure the slide is completely flat to seal the gasket firmly into place. This will ensure an even staining. Fill the slide clip with 2-3 ml of Dako Wash Solution (AR102) and presoak the tissue for a minimum of 5 minutes. This will condition the slide surface to aid in fluid spreading during the session. Store the slide clips in a clean and dry place to ensure a well-sealed gasket every time. Figure 4. SYSTEM SETTINGS screen depicting automatic maintenance settings upon installation (default status). Connection 2010 225
Figure 5. SYSTEM SETTINGS screen depicting possible privilege settings for User groups. 226 Connection 2010
Reagents Every reagent pack specifies a storage temperature on the label. Each reagent kit comes with a package insert that includes the specifications for use. These include priming instructions, recommended control tissues, and intended use. Following the instructions given in the package insert is important for a good and consistent staining of the tissue. In other words, the staining quality of the last slide should be as good as the first one. Some tips for using reagents/reagent packs are: Reagent packs stored in a cold room should be brought to ambient room temperature before priming for staining use. This will usually take 30-45 minutes. If packs are cold at session startup, the chemicals continue to reach ambient temperature throughout the session. This can yield a varying temperature dispense from first to last slide. Reagent packs should not be shaken, but gently mixed prior to each session by inverting the pack several times. Some chemicals foam or release gases during motion which can damage plastic parts causing erroneous dispense behaviors. Figure 6. A 2D slide label demonstrating customized information for quick identification. Each reagent pack should be primed until a steady stream is obtained. A good technique is to point the tip away from you into an approved waste container. This is done by holding the pack at a slight angle, tapping the side gently and priming with a plunge of the dispenser. Priming ensures that no air is left in the bottle neck during the dispense. NOTE: A steady prime will equal 250 µl. Dako provides extra reagent for each test pack to accommodate priming. Reagent packs should be placed on the carousel immediately after priming while maintaining them in a tip-down orientation. This will ensure a first full dispense and that no air is left. Reagent packs should be stored at their labeled temperature in a tip-down orientation, using Dako provided reagent storage trays, AR409. It is advised not to leave reagent packs on the carousel when the reagents are not in use. Proper storage will maintain manufacture label shelf life. Refrain from writing on the spine of the reagent packet labels as this may interfere with the barcode scanning. If the pack will not scan, the session will not begin. NOTE: The handheld 2D barcode scanner can be used at any time to verify inventory. In summary, making the hardware and software work together along with other parameters such as using the right slides, reagents/reagent packs and chemistry is the first step toward mastering the automated staining process. With the tips described in this article, you should be able to obtain consistent quality staining results without making extensive changes to the system or using additional time in the laboratory. Reference Brown RW (Ed.). Histologic Preparations: Common Problems and Their Solutions. College of American Pathologists, Northfield IL, 2009, pp 86-91. Connection 2010 227