Erweiterte serologische Verträglichkeitstestung in Geltechnik

Abstract

Expanded serological compatibility tests were carried out as follows: major compatibility test (with plasma): NaCl, antiglobulin technique (AGT), bromelin; antibody screening test (AST, with plasma): NaCl, AGT, papain; AB control test of the blood units (erythrocytes); AB, RhD control test of the recipient’s erythrocytes; autocontrol in bromelin; autocontrol in AGT; CDE control of the blood units (erythrocytes) in Rhesus-negative transfusions. As a result of a reduced need of materials and an increased sensitivity, the gel technique is superior to the tube technique. Cases at risk are recognized in good time by means of the AST within the compatibility testing. When unexpected intraoperative additional transfusions are necessary, blood units can be safely delivered and transfused without waiting for cross-matching when there is a negative AST result. The need for cross-matched blood units on hand can therefore be minimized. This procedure is a step in the direction of Type & Screen, which is compatible with the current German standards. Starting the compatibility tests initially at 37 °C avoids cold agglutinations irrelevant for transfusion. The incubation at various temperatures, which is possible with the same material when using the tube technique, is not necessary. We have solved the problem of fibrin in plasma with short-time defibrination. Because of the known advantages the gel technique was able to supersede the compatibility testing in tubes which we have carried out in the above-mentioned combination since 1978.