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Parween S, Bhatnagar I, Bhosale S, Paradkar S, Michael IJ, Rao CM, Asthana A. Cross-linked chitosan biofunctionalized paper-based microfluidic device towards long term stabilization of blood typing antibodies. Int J Biol Macromol 2020; 163:1233-1239. [DOI: 10.1016/j.ijbiomac.2020.07.075] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 06/24/2020] [Accepted: 07/08/2020] [Indexed: 10/23/2022]
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Lieberman L, Callum J, Cohen R, Cserti-Gazdewich C, Ladhani NNN, Buckstein J, Pendergrast J, Lin Y. Impact of red blood cell alloimmunization on fetal and neonatal outcomes: A single center cohort study. Transfusion 2020; 60:2537-2546. [PMID: 32893897 DOI: 10.1111/trf.16061] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 07/03/2020] [Accepted: 07/08/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Alloimmunization can impact both the fetus and neonate. STUDY OBJECTIVES (a) calculate the incidence of clinically significant RBC isoimmunization during pregnancy, (b) review maternal management and neonatal outcomes, (c) assess the value of prenatal and postnatal serological testing in predicting neonatal outcomes. STUDY DESIGN AND METHODS A retrospective audit of consecutive alloimmunized pregnancies was conducted. Data collected included demographics, clinical outcomes, and laboratory results. Outcomes included: incidence of alloimmunization; outcomes for neonates with and without the cognate antigen; and sensitivity and specificity of antibody titration testing in predicting hemolytic disease of the fetus and newborn (HDFN). RESULTS Over 6 years, 128 pregnant women (0.4%) were alloimmunized with 162 alloantibodies; anti-E was the most common alloantibody (51/162; 31%). Intrauterine transfusions (IUTs) were employed in 2 (3%) of 71 mothers of cognate antigen positive (CoAg+) neonates. Of 74 CoAg+ neonates, 58% required observation alone, 23% intensive phototherapy, 9% top up transfusion, and 3% exchange transfusion; no fetal or neonatal deaths occurred. HDFN was diagnosed in 28% (21/74) of neonates; anti-D was the most common cause. The sensitivity and specificity of the critical gel titer >32 in predicting HDFN were 76% and 75%, respectively (negative predictive value 95%; positive predictive value 36%). The sensitivity and specificity of a positive direct antiglobulin test (DAT) in predicting HDFN were 90% and 58%, respectively (NPV 97%; PPV 29%). CONCLUSION Morbidity and mortality related to HDFN was low; most alloimmunized pregnancies needed minimal intervention. Titers of >32 by gel warrant additional monitoring during pregnancy.
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Affiliation(s)
- Lani Lieberman
- Department of Clinical Pathology, University Health Network, Toronto, Ontario, Canada.,Department of Laboratory Medicine & Pathobiology, University of Toronto, Toronto, Ontario, Canada.,Department of Laboratory Medicine and Molecular Diagnostics, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.,Education and Safety in Transfusion (QUEST) Research Program, University of Toronto Quality in Utilization, Toronto, Ontario, Canada
| | - Jeannie Callum
- Department of Laboratory Medicine & Pathobiology, University of Toronto, Toronto, Ontario, Canada.,Department of Laboratory Medicine and Molecular Diagnostics, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.,Education and Safety in Transfusion (QUEST) Research Program, University of Toronto Quality in Utilization, Toronto, Ontario, Canada
| | - Robert Cohen
- Department of Laboratory Medicine and Molecular Diagnostics, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Christine Cserti-Gazdewich
- Department of Clinical Pathology, University Health Network, Toronto, Ontario, Canada.,Department of Laboratory Medicine & Pathobiology, University of Toronto, Toronto, Ontario, Canada.,Education and Safety in Transfusion (QUEST) Research Program, University of Toronto Quality in Utilization, Toronto, Ontario, Canada
| | - Noor Niyar N Ladhani
- Department of Laboratory Medicine & Pathobiology, University of Toronto, Toronto, Ontario, Canada.,Department of Laboratory Medicine and Molecular Diagnostics, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Jonah Buckstein
- Department of Laboratory Medicine and Molecular Diagnostics, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Jacob Pendergrast
- Department of Clinical Pathology, University Health Network, Toronto, Ontario, Canada.,Department of Laboratory Medicine & Pathobiology, University of Toronto, Toronto, Ontario, Canada.,Education and Safety in Transfusion (QUEST) Research Program, University of Toronto Quality in Utilization, Toronto, Ontario, Canada
| | - Yulia Lin
- Department of Laboratory Medicine & Pathobiology, University of Toronto, Toronto, Ontario, Canada.,Department of Laboratory Medicine and Molecular Diagnostics, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.,Education and Safety in Transfusion (QUEST) Research Program, University of Toronto Quality in Utilization, Toronto, Ontario, Canada
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Raos M, Zunec R, Mocibob M, Gojceta K, Lukic M, Golubic Cepulic B. Susceptible and protective HLA‐DR and HLA‐DQ alleles for Fy
a
alloimmunization in the Croatian population. Transfusion 2018; 59:1118-1124. [DOI: 10.1111/trf.15087] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 10/11/2018] [Accepted: 10/30/2018] [Indexed: 01/28/2023]
Affiliation(s)
- Mirela Raos
- Clinical Department of Transfusion Medicine and Transplantation BiologyUniversity Hospital Center Zagreb Zagreb Croatia
| | - Renata Zunec
- Clinical Department of Transfusion Medicine and Transplantation BiologyUniversity Hospital Center Zagreb Zagreb Croatia
| | - Marko Mocibob
- Department of Chemistry, Faculty of ScienceUniversity of Zagreb Zagreb Croatia
| | - Koraljka Gojceta
- Clinical Department of Transfusion Medicine and Transplantation BiologyUniversity Hospital Center Zagreb Zagreb Croatia
| | - Marija Lukic
- Clinical Department of Transfusion Medicine and Transplantation BiologyUniversity Hospital Center Zagreb Zagreb Croatia
| | - Branka Golubic Cepulic
- Clinical Department of Transfusion Medicine and Transplantation BiologyUniversity Hospital Center Zagreb Zagreb Croatia
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4
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Paper-based assay for red blood cell antigen typing by the indirect antiglobulin test. Anal Bioanal Chem 2016; 408:5231-8. [PMID: 27185543 DOI: 10.1007/s00216-016-9617-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Revised: 04/20/2016] [Accepted: 05/02/2016] [Indexed: 12/11/2022]
Abstract
A rapid and simple paper-based elution assay for red blood cell antigen typing by the indirect antiglobulin test (IAT) was established. This allows to type blood using IgG antibodies for the important blood groups in which IgM antibodies do not exist. Red blood cells incubated with IgG anti-D were washed with saline and spotted onto the paper assay pre-treated with anti-IgG. The blood spot was eluted with an elution buffer solution in a chromatography tank. Positive samples were identified by the agglutinated and fixed red blood cells on the original spotting area, while red blood cells from negative samples completely eluted away from the spot of origin. Optimum concentrations for both anti-IgG and anti-D were identified to eliminate the washing step after the incubation phase. Based on the no-washing procedure, the critical variables were investigated to establish the optimal conditions for the paper-based assay. Two hundred ten donor blood samples were tested in optimal conditions for the paper test with anti-D and anti-Kell. Positive and negative samples were clearly distinguished. This assay opens up new applications of the IAT on paper including antibody detection and blood donor-recipient crossmatching and extends its uses into non-blood typing applications with IgG antibody-based diagnostics. Graphical abstract A rapid and simple paper-based assay for red blood cell antigen typing by the indirect antiglobulin test.
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Songjaroen T, Laiwattanapaisal W. Simultaneous forward and reverse ABO blood group typing using a paper-based device and barcode-like interpretation. Anal Chim Acta 2016; 921:67-76. [DOI: 10.1016/j.aca.2016.03.047] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Revised: 03/22/2016] [Accepted: 03/26/2016] [Indexed: 11/28/2022]
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6
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Park ES, Jo KI, Shin JW, Park R, Choi TY, Bang HI, Chai GR, Yun SG. Comparison of total and IgG ABO antibody titers in healthy individuals by using tube and column agglutination techniques. Ann Lab Med 2014; 34:223-9. [PMID: 24790910 PMCID: PMC3999321 DOI: 10.3343/alm.2014.34.3.223] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2013] [Revised: 10/22/2013] [Accepted: 02/24/2014] [Indexed: 11/19/2022] Open
Abstract
Background Most immune reactions related to transfusion and transplantation are caused by IgM ABO antibodies. However, IgG also plays an important role in these reactions. Therefore, a method to measure antibodies, including IgG, is necessary. We investigated ABO antibody titers of healthy individuals using a column agglutination technique (CAT) with or without dithiothreitol (DTT) and compared them with titers obtained using a conventional tube method. Methods Among healthy adults who underwent a medical examination, 180 individuals (60 with blood group A, 60 with group B, and 60 with group O) were selected. Antibody titrations were performed using the immediate spin (IS) tube, anti-human globulin (AHG) tube, and CAT with or without DTT methods. Results Higher median values of anti-B and anti-A titers in groups A and B individuals, respectively, were obtained using the IS method than using the AHG method. Higher values for group O individuals were obtained using the AHG method. Higher median titers of anti-B and anti-A in group O individuals were obtained using CAT without DTT than using the AHG method. Median titers of anti-B and anti-A in all blood groups were higher in CAT without DTT than in CAT with DTT, especially for group O individuals. Conclusions We recommend CAT with and without DTT for titration of anti-A and anti-B, especially in group O individuals, to provide more sensitive results that include IgG data. Adjustment of insurance coverage of fees associated with antibody titration might be necessary, considering the actual cost of reagents and personnel.
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Affiliation(s)
- Eun Su Park
- Department of Laboratory Medicine, Soonchunhyang University Hospital, Seoul, Korea
| | - Kyung Il Jo
- Department of Laboratory Medicine, Soonchunhyang University Hospital, Seoul, Korea
| | - Jeong Won Shin
- Department of Laboratory Medicine, Soonchunhyang University Hospital, Seoul, Korea
| | - Rojin Park
- Department of Laboratory Medicine, Soonchunhyang University Hospital, Seoul, Korea
| | - Tae Yoon Choi
- Department of Laboratory Medicine, Soonchunhyang University Hospital, Seoul, Korea
| | - Hae In Bang
- Department of Laboratory Medicine, Soonchunhyang University Hospital, Seoul, Korea
| | - Gum Ran Chai
- Department of Laboratory Medicine, Soonchunhyang University Hospital, Seoul, Korea
| | - Soon Gyu Yun
- Department of Laboratory Medicine, Soonchunhyang University Hospital, Seoul, Korea. ; Department of Laboratory Medicine, Kangwon National University School of Medicine, Chuncheon, Korea
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Shin JW. Unexpected red cell antibody detection by conditional combination of LISS/Coombs and NaCl/Enzyme gel tests at a tertiary care hospital in Korea: A 5-year study. Blood Res 2013; 48:217-21. [PMID: 24086943 PMCID: PMC3786283 DOI: 10.5045/br.2013.48.3.217] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2013] [Revised: 02/22/2013] [Accepted: 07/12/2013] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND A combination of the LISS/Coombs and enzyme methods is recommended for identifying unexpected antibodies. However, many laboratories in which tests are to be performed within the limits of medical fees covered by insurance, use only the LISS/Coombs method because the permissible medical fee is low as compared to the price of reagents required for both methods. The NaCl/Enzyme gel is used as a secondary assay when the LISS/Coombs gel test yields inconclusive results. We compared the frequency of unexpected antibody identified by LISS/Coombs gel with that obtained by the conditional combination of LISS/Coombs and NaCl/Enzyme gels. We aimed at establishing evidence-based guidelines for antibody testing. METHODS From June 2007 to June 2012, antibody screening was performed for 69,986 samples; subsequently, antibodies were identified in samples showing positive screening results. These initial screenings and identifications were performed using the LISS/Coombs gel. We considered the results "inconclusive" when specific antibodies were not identified or reactions were too weak for accurate interpretation. For the inconclusive samples, we subsequently used NaCl/Enzyme gels. RESULTS The overall detection rate of unexpected antibodies was 1.23%. Among the samples analyzed using NaCl/Enzyme gels, 40.2% showed results different from those obtained using LISS/Coombs gels. Moreover, 41.9% of samples with nonspecific reactions in LISS/Coombs gels showed clinically significant Rh or Kidd antibodies with NaCl/Enzyme gels. CONCLUSION Considering both patient safety and cost effectiveness, we recommend the use of conditional combination of LISS/Coombs and NaCl/Enzyme gels for antibody detection, especially in laboratories that must perform tests within an established budget.
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Affiliation(s)
- Jeong Won Shin
- Department of Laboratory Medicine, Soonchunhyang University Hospital, Seoul, Korea
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Al-Tamimi M, Shen W, Zeineddine R, Tran H, Garnier G. Validation of Paper-Based Assay for Rapid Blood Typing. Anal Chem 2012; 84:1661-8. [DOI: 10.1021/ac202948t] [Citation(s) in RCA: 95] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Mohammad Al-Tamimi
- Australian Pulp and Paper Institute,
Department of Chemical Engineering, Monash University, Australia
| | - Wei Shen
- Australian Pulp and Paper Institute,
Department of Chemical Engineering, Monash University, Australia
| | | | | | - Gil Garnier
- Australian Pulp and Paper Institute,
Department of Chemical Engineering, Monash University, Australia
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9
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Jarujamrus P, Tian J, Li X, Siripinyanond A, Shiowatana J, Shen W. Mechanisms of red blood cells agglutination in antibody-treated paper. Analyst 2012; 137:2205-10. [DOI: 10.1039/c2an15798e] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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Lange J, Selleng K, Heddle NM, Traore A, Greinacher A. Coombs' crossmatch after negative antibody screening--a retrospective observational study comparing the tube test and the microcolumn technology. Vox Sang 2010; 98:e269-75. [PMID: 20635477 DOI: 10.1111/j.1423-0410.2009.01278.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- J Lange
- Institute of Immunology and Transfusion Medicine, Ernst-Moritz-Arndt University Greifswald, Germany.
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11
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AuBuchon JP, de Wildt-Eggen J, Dumont LJ. Reducing the variation in performance of antibody titrations. Vox Sang 2008; 95:57-65. [DOI: 10.1111/j.1423-0410.2008.01043.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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12
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AuBuchon JP, de Wildt-Eggen J, Dumont LJ. Reducing the Variation in Performance of Antibody Titrations. Arch Pathol Lab Med 2008; 132:1194-201. [DOI: 10.5858/2008-132-1194-rtvipo] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2008] [Indexed: 11/06/2022]
Abstract
Abstract
Background.—Antibody titration is difficult to standardize. We investigated whether a detailed, uniform procedure for antibody titration would reduce variation in both tube-based and gel card titres in an international study.
Methods.—Laboratories (n = 35) tested proficiency testing material provided by the College of American Pathologists each according to (i) their routine method; (ii) a detailed, uniform method; and (iii) the uniform method titrating the serum sample against a red cell of specified phenotype (D+ C− c+ E+ e− for anti-D; A1 for anti-A) instead of the red cell of the same phenotype provided in the proficiency testing kit. Uniform method results were reported with 1+ and w+ end-points. Paired statistical analyses of variance were conducted using the F-test.
Results.—The variance between laboratories was not significantly reduced with the uniform method using a 1+ end-point. However, a statistically significant reduction in the variance of anti-D and anti-A titres by the tube-based uniform technique after 37°C incubation and conversion to the antiglobulin (AHG) phase was seen when 19 laboratories reanalysed their results using a w+ end-point. Too few laboratories reported results with a w+ end-point in gel card testing to allow analysis. Titration against red cells of the specified phenotype provided by the participating laboratory did not appear to introduce additional variance. Overall, results reported based on the gel card technique at the AHG phase (1+ end-point) showed reduced variance compared to tube-based techniques.
Conclusions.—A detailed, uniform method for antibody titration at 37°C and read at the AHG phase in a tube-based method with a w+ end-point reduced interlaboratory variability.
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Affiliation(s)
- J. P. AuBuchon
- From the Department of Pathology, Dartmouth-Hitchcock Medical Center, Lebanon, NH (Drs AuBuchon and Dumont); and Sanquin, North East, Groningen, The Netherlands (Dr Wildt-Eggen)
| | - J. de Wildt-Eggen
- From the Department of Pathology, Dartmouth-Hitchcock Medical Center, Lebanon, NH (Drs AuBuchon and Dumont); and Sanquin, North East, Groningen, The Netherlands (Dr Wildt-Eggen)
| | - L. J. Dumont
- From the Department of Pathology, Dartmouth-Hitchcock Medical Center, Lebanon, NH (Drs AuBuchon and Dumont); and Sanquin, North East, Groningen, The Netherlands (Dr Wildt-Eggen)
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Robb JS, Roy DJ, Ghazal P, Allan J, Petrik J. Development of non-agglutination microarray blood grouping. Transfus Med 2006; 16:119-29. [PMID: 16623918 DOI: 10.1111/j.1365-3148.2005.00628.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Microarray technology provides an opportunity to monitor multiple parameters simultaneously. High-throughput applications such as blood donation screening could greatly benefit from performing various tests on a single testing platform. Blood grouping represents one part of the donation testing complementing the screening for blood-borne pathogens. Blood group serology traditionally exploited agglutination as the detection method. In this investigation, we have adapted blood grouping reactions to a solid-phase microarray substrate in a non-agglutination reaction format as an initial step in the development of a combined microarray testing platform. We have investigated immobilization of proprietary antibodies on multiple surfaces and monitored their performance under various reaction conditions. For the first time, highly specific blood grouping has been achieved on a planar microarray using directly labelled erythrocytes or a secondary labelled reagent using fluorescent signal end point readout. We have also complemented microarray data with a label-free, surface plasmon resonance-based Biacore platform data and used the real time quantitative measurement to rank anti-A antibodies according to the strength of reaction with the immobilized synthetic blood group antigen A.
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Affiliation(s)
- J S Robb
- Alba Bioscience, University of Edinburgh, Edinburgh, UK
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Cid J, Nogués N, Montero R, Hurtado M, Briega A, Parra R. Comparison of three microtube column agglutination systems for antibody screening: DG Gel, DiaMed-ID and Ortho BioVue. Transfus Med 2006; 16:131-6. [PMID: 16623919 DOI: 10.1111/j.1365-3148.2006.00655.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The aims of the present study were to evaluate the estimated diagnostic accuracy of a new microtube column agglutination system (DG Gel, Diagnostic Grifols, Barcelona, Spain), to analyse the antibody reactivity and to compare the data with the two well-established DiaMed-ID and Ortho BioVue systems. We collected 3024 consecutive samples from blood donors, transfusion recipients and pregnant women, and 100 samples containing antibodies of known specificity. All these samples were tested in parallel by the three microtube agglutination systems. The estimated sensitivity was 100% for DG Gel and Ortho BioVue and 97.58% for DiaMed-ID. The estimated specificity was 99.93% for Ortho BioVue and 100% for DiaMed-ID and DG Gel. The score mean and range of the antibody titration of DG Gel, DiaMed-ID and Ortho BioVue were 34.31 (5-119), 30.3 (3-121) and 37.38 (3-112), respectively. All three column agglutination systems work well showing a high estimated diagnostic accuracy.
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Affiliation(s)
- J Cid
- Blood and Tissue Bank, Barcelona, Spain.
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Melo L, Pellegrino J, Bianco C, Castilho L. Twelve years of the Brazilian External Quality Assessment Program in Immunohematology: benefits of the program. J Clin Lab Anal 2005; 19:209-18. [PMID: 16170810 PMCID: PMC6808094 DOI: 10.1002/jcla.20080] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
The Brazilian External Quality Assessment Program in Immunohematology (BEQAPI) was introduced with the objective of evaluating the quality of diagnosis in immunohematology. From 1992 to 2003, proficiency tests for ABO grouping, Rh (D, C, c, E, e), K phenotyping, direct antiglobulin testing (DAT), antibody screening (AS), and antibody identification (AI) were performed. A total of 41 evaluations were carried out in 223 institutions. Over the period of 12 years, the program included 8,014 ABO typing, 8,000 RhD typing, 5,193 Rh typing (C, c, E, e), 5,101 K phenotyping, 7,939 AS, 4,533 AI, and 7,912 DATs. Erroneous responses were classified as clerical, technical, or undetermined. A substantial proportion of erroneous responses due to clerical errors occurred in ABO typing (76/76 errors), RhD typing (34/58 errors), and Rh phenotyping (50/73 errors). Technical errors occurred predominantly for weak D (91/95 errors), AS (252/301 errors), and AI (321/335 errors). Based on these results, since 1996, participants have received "Questions and Case Studies" in Immunohematology as an incentive for training and education. The results of the present study show an improvement in the performance of participants in the course of the program. We found that a well-organized external proficiency program can contribute to the improvement of quality of testing in Immunohematology.
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Weisbach V, Ziener A, Zimmermann R, Glaser A, Zingsem J, Eckstein R. Comparison of the performance of four microtube column agglutination systems in the detection of red cell alloantibodies. Transfusion 1999; 39:1045-50. [PMID: 10532596 DOI: 10.1046/j.1537-2995.1999.39101045.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND The purpose of this study was to compare the performance of four currently available microtube column agglutination systems in the detection of red cell alloantibodies to that of the standard tube low-ionic-strength solution (LISS) indirect antiglobulin test (IAT) (tube LISS-IAT). STUDY DESIGN AND METHODS In a comparative study, 172 sera, previously demonstrated to contain red cell alloantibodies, were tested in parallel by the tube LISS-IAT and three microtube column agglutination techniques (DiaMed-ID, Ortho BioVue, and Sanofi-Pasteur Scangel) and one affinity-adherence test system (Gamma ReACT). Tests were performed simultaneously by a single person on freshly thawed sera that had been frozen at -20 degrees C. RESULTS The rate of detection of clinically significant alloantibodies (n = 154) in microtube column systems was very similar. One hundred forty-one sera (91.6%) reacted in the DiaMed-ID, 139 (90.3%) in the ReACT, 139 (90.3%) in the BioVue, and 142 (92.2%) in the Scangel. Only 117 (76.0%) of these sera reacted in the tube LISS-IAT. The detection rates for 18 antibodies of minor clinical significance (anti-M, -N, -P1, -Le(a), and -Le(b)) varied among the test systems: DiaMed-ID, 5 (28%); ReACT, 7 (39%); BioVue, 14 (78%); Scangel, 10 (56%); and tube LISS-IAT, 6 (33%). Antibody reactivity as determined by titer and score was very similar in all microtube column systems and higher in these systems than in the tube LISS-IAT. CONCLUSION The sensitivity of all four microtube column systems in the detection of clinically significant red cell alloantibodies was similar and was markedly superior to that of the tube LISS-IAT. An individual cost-benefit analysis should be performed in every institution to decide whether a microtube column system should be applied. If so, the antibody screen in the microtube column agglutination system should ideally be performed in advance of the crossmatch to provide time to screen for compatible units.
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Affiliation(s)
- V Weisbach
- Department of Transfusion Medicine and Hemostaseology, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany.
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