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KMID : 0384119860060020473
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Korean Journal of Clinical Pathology
1986 Volume.6 No. 2 p.473 ~ p.474
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Screening of Irregular Red Cell Antibodies by Microplated Method in Transfusion Candidates
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Abstract
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Screening of irregular red cell antibodies i n transfusion candidates has many advantages and antiglobulin phase of major cross match can be obmitted in the recipients with negative antibody screening tests and no previous record of clinically significant antibody, which is otherwise essential for transfusion practices required by AABB Standards. However, because of reagent cost, technician time arid probably of lower -incidence of transfusion reactions, full crossmatch and/or irregular antibody screening including antiglobulin phase are not performed routinely in most of the blood bank laboratories in Korea.
In recent years many blood bank procedures have been partially automated using microplate system, which have many advantages and usually U plates have been used. We tried microplate method with V shape plates for irregular antibody
screening and identification in transfusion candidates. 13, 511 sera from hospitalized patients were tested, comprising 75% of all serum samples from transfusion candidates during one year period and the microplate method included saline room temperature, saline 37°C and antiglobulin phases.
The results are as follows:
1. With the, optimal test parameters of our microplate method, the test sensitivity and specificity of detecting irregular antibodies were at least as good as that of the standard tube method, but AABB recommended microplate method (1985) gave slightly better sensitivity and agglutination pattern.
2. We used pooled screening cells (two individual screening cells of commercial origin or pooled 0 cells from 3 donors), which could affect the sensitivity of antibody- : e ectiot,- Pooled cells compared to single cells gave loz:,;e,aggl_{tination titer; 1 titer lower for saline reacting cold antibodies and titere
lowerr for antiglobulin phase reacting antibodies.
3. Overall incidence of irregular red cell antibodies among 13, 511 sera from
hospitalized transfusion candidates was´
Q. 51%; majority of which were cold
antibodies (84, If/c) and the incidence of warm antibodies (15, g/) was very low, comprising Q.08% of all serum samples tested. This overall antibody incidence might be somewhat lower than true incidence, due to technical factors such as using pooled screening cells and not including other sensitive methods like enzyme technigue.
4. The microplate method is simple, easy to perform with larger number of samples and very economical compared to standard tube method that it can be used as a routine antibody screening procedure for all transfusion candidates for safe transfusion practices, reserving complete major crossmatch test including antiglobulin phase for the limited number of patients
with clinically significant antibodies.
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