Abstract
The WHO recommends that pre-transfusion testing should include ABO/RhD grouping followed by screening for red blood cell (RBC) alloantibodies using the indirect antiglobulin test (IAT). However, in Uganda, current practice does not include RBC alloantibody screening. To assess the utility of 'home-made' reagent RBCs in alloantibody screening. In a laboratory-based study, group O RhD positive volunteer donors were recruited and their extended phenotype performed for C, c, E, e, K, Fya, Fyb Jkb, S and s antigens. These 'home-made' reagent RBCs were preserved using Alsever's solution and alloantibody detection tests performed. For quality assurance, repeat alloantibody screening of patients' samples was done at Bloodworks Northwest Laboratory in Seattle, United States. A total of 36 group O RhD positive individuals were recruited as reagent RBC donors (median age, 25 years; range, 21 - 58 years; male-to-female ratio, 1.6:1). Out of the 311 IATs performed, 32 (10.3%) were positive. Confirmatory IAT testing in the United States was in agreement with the findings in Uganda. Use of 'home-made' reagent RBCs during pre-transfusion testing in Uganda is feasible. We recommend the introduction of pre-transfusion IAT alloantibody screening in Uganda using 'home-made' reagent RBCs to improve transfusion safety.
Highlights
According to the World Health Organization (WHO), African Health SciencesAfrican Health Sciences, Vol 21 Issue 2, June, 2021 testing
Background: The WHO recommends that pre-transfusion testing should include ABO/RhD grouping followed by screening for red blood cell (RBC) alloantibodies using the indirect antiglobulin test (IAT)
Previous reports indicated that the introduction of pre-transfusion RBC alloantibody screening in Uganda would be cost-effective[10], there have been concerns on the additional costs involved and the lack of funds for the procurement of commercial reagent RBC supplies obtained from overseas since there are no African manufacturers of these specialized reagents
Summary
According to the World Health Organization (WHO), African Health SciencesAfrican Health Sciences, Vol 21 Issue 2, June, 2021 testing. In high index settings reagent RBC panels are sourced, packaged and prepared by commercial manufacturers and supplied to hospital blood banks for use in testing patient samples. A more plausible solution to this challenge is the use of the traditional tube test and ‘home-made’ reagent RBCs from local blood group O RhD positive volunteer donors at regional blood centers of the Uganda Blood Transfusion Service (UBTS). Materials and methods: In a laboratory-based study, group O RhD positive volunteer donors were recruited and their extended phenotype performed for C, c, E, e, K, Fya, Fyb Jkb, S and s antigens These ‘home-made’ reagent RBCs were preserved using Alsever’s solution and alloantibody detection tests performed.
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