We use Reagent Red Blood Cells 0.8% Selectogen (Ortho clinical Diagnostics) for two-cell screen and Reagent Red Blood Cells 0.8% Resolve panel A Antigram Antigen Profile (Ortho Clinical Diagnostics) for detection and defining pattern of antibodies.Ī total of 149 patients were identified from the blood bank database, which were included in study group. In our institution, the patients who have a positive antibody screen get a cross match by gel technology. The control group was composed of patients with a definite positive antibody screen with an identifiable antibody during the same period. Patients in the screened group who had a positive antibody identified in previous screening were excluded from the study group. The patients were also studied for rise in hemoglobin per unit of red cell (excluding patients with active blood loss or hemolysis). The charts were then retrospectively screened for clinical diagnosis, antibody screen and ABID, repeat screen, blood transfusions given, if any, and occurrence of transfusion reactions. This study was undertaken to review the clinical implications of a positive antibody screen with inconclusive ABID.Īll patients who had an antibody screen performed and the antibody identification was inconclusive during Jan 1 st 2005 to Dec 31 st 2010, were identified from the blood bank database of our hospital. However, there is great paucity of literature regarding the scenario where the antibody screen is positive but the antibody identification (ABID) is inconclusive, to see if this has any clinical implications. If the antibody screen is negative, they recommend only ABO/RH compatibility testing to be done before transfusion. An inconclusive antibody screen is defined as test reactive for gel screen (which is a two cell screen) and no defined pattern on antibody identification panel.Īmerican Association of Blood Banking states that if an antibody screen is positive, an attempt should be made to identify the antibody and cross match for the same along with ABO and RH. A positive antibody screen can sometimes be associated with inconclusive antibody identification. They are thought not to have much clinical significance. Most of these antibodies are IgM type, also known as nuisance antibodies. However, it is cost effective to perform a confirmatory tube test with PEG enhancement because 214 SPRCA assay samples were interpreted as having a negative antibody screen, thus allowing the release of valuable blood components for transfusion.The routine blood type and screen involves screening for unexpected antibodies, in addition to checking the ABO group and RH type. We report a high specificity for antibody screening using the SPRCA assay. The remaining 214 (68.4%) were negative, giving specificity for the SPRCA assay of 99.6 percent (48,985/ 49,199). Of these, 99 (31.6%) samples remained positive when tested with PEG enhancement. Of 49,084 samples, 313 (0.64%) were positive by the SPRCA assay. Testing was performed with strict adherence to the manufacturers' inserts. Further identification of positive samples was performed using a PEG enhancement method. Over a 5-month period, 49,084 donor serum or plasma samples were tested using the SPRCA assay. Positive results are then confirmed using a tube technique with polyethylene glycol (PEG) enhancement due to reported higher specificity than with SPRCA. Our blood bank routinely screens donors for antibodies using a solid-phase red cell adherence (SPRCA) assay.
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