File Name: antibody screening and identification .zip
This Guideline is intended to assist transfusion services with the identification of antibodies in patients with a reactive pretransfusion antibody detection test. Its major sections address 1 routine testing and interpretation guidelines, 2 additional guidance and testing, and 3 unusual antibody identification situations.
- Antibody Detection and Identification
- A comparison of three column agglutination tests for red blood cell alloantibody identification
- Guidelines for Antibody Identification
Antibody Detection and Identification
The aim of the blood transfusion service should be to provide effective blood and blood components, which are as safe as possible and adequate to meet patient's need. To achieve safe blood transfusion practice, many blood transfusion center in India follow routine type and screen protocol for all patient's and donor's blood samples to detect unexpected alloantibodies. The present study is aimed at assessing the frequency and type of unexpected red cell alloantibodies in general patient population and donors at a tertiary care teaching hospital in western India. Positive sample in three cell screening panel was further evaluated for identification of specific alloantibody with eleven cell identification panel by column agglutination technique. Results were recorded, and data were analyzed to calculate the frequency of unexpected alloantibody. A total of 74, patient samples and 80, donor samples were processed for type and screen.
Several sensitive methods are available for red blood cell RBC antibody screening. Among these, gel and glass card systems have demonstrated comparably good performance in retrospective studies and are widely used in routine patient diagnostics, but their performance in prospective studies has not been sufficiently characterised. Gel card Bio-Rad DiaMed and glass bead-based Ortho Clinical Diagnostics column agglutination technologies were used to screen for antibodies prospectively group A and for antibody identification in stored and fresh samples known to contain RBC antibodies retrospectively group B. RBC-reactive antibodies were detected in 22 of group A samples, three of which tested positive only by gel card agglutination, and four only by glass bead agglutination including one false positive each. Group B comprised sera with known antibodies: 33 of these samples contained 36 antibodies detected only by gel card agglutination, whereas 9 samples contained antibodies detectable only by glass bead-based agglutination.
The development of alloantibodies can significantly complicate transfusion therapy and results in difficulties in cross-matching of blood. Most literature on alloimmunization is limited to multitransfused individuals, with very few studies on the general hospital patients. This study was aimed at assessing the frequency and type of unexpected red cell antibodies in the general patient population at a multispecialty tertiary care centre in New Delhi, India. The results of 49, antibody screening tests carried out on patients, from January to December were analyzed. The clinical and transfusion records were reviewed. The data were compiled and statistically analysed. A total of 49, 29,;
A comparison of three column agglutination tests for red blood cell alloantibody identification
Antibody detection and identification are performed by testing patient serum or plasma with reagent red cells. Agglutination or hemolysis indicates sensitization of the reagent red cells by an unexpected antibody in the patient's serum. The reagent red cells come with an antigram or antigen profile sheet. The antigram shows the phenotype of each reagent cell used. Antibody detection is performed using an antibody screening test.
Metrics details. Commercial kits of column tests for pre-transfusion testing have progressively replaced conventional tube tests in most laboratories. Aim of this study was to compare three commercial test cell panels for the identification of irregular red blood cell RBC alloantibodies. Alloantibody identification was possible in 38 samples, of which identical identification was shown in 33 samples by all methods. Although differences in sensitivities were seen for specific antibodies, the three methods showed comparable performance for the identification of RBC alloantibodies.
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Guidelines for Antibody Identification
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If the antibody screen is positive, the specificity of the antibody is identified by testing the serum against a panel of 8 to 20 Group O RBCs of varying phenotypes. The pattern of positive and negative reactions with these cells identifies the antigen against which the antibody is directed. The panel should also be observed to:. If a clinically significant antibody is identified, only red cells negative for the relevant antigen will be selected for crossmatching and transfusion. For added safety, an AHG crossmatch is also performed.
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