Unexpected Antibody Screening Research Articles

Challenges in blood transfusion caused by anti-Hr0: A rare case of D-- Phenotype in Asia Abstract

Introduction D–Phenotype is linked to abnormal expression of RHCE gene. Consequently, individuals with this condition may develop antibodies against high-prevalence Rh antigens when exposed to a normal Rh phenotype, leading to challenges in blood matching.Case presentationA 90-year-old male was admitted to the hospital due to prostatitis and acute retention of urinary. Surgery was planned after evaluation by urologist. A request was made for 2 units of red blood cells (RBC). The result for unexpected antibody screening was positive, and the antibody was identified as anti-Hr0 alloantibody , a rare RHCE * CE-D (5) – CE was discovered by genetic testing. The patient has only one history of blood transfusion, which may result in the production of the anti-Hr0 antibody. Compatible blood donors for this patient were not found, even after extensive screening.ConclusionThis report records a rare case of a D-- phenotype individual who produced anti-Hr0 alloantibody. Subsequent analysis of RH gene sequencing revealed a genotype that has not been previously reported in Asia.

Analysis of Rhesus (Rh) Antigen Distributions in Donors and Multi-transfused Patients for Phenotype-Matched Transfusion

Knowledge about the frequency of Rh blood group systems in the local population help build a donor pool for multi-transfused patients and provide antigen-negative compatible blood for patients with alloantibodies. ABO and Rh antigens were identified for blood donors and patients before transfusion. The antiglobulin test based on the micro-column gel method was used to perform unexpected antibody screening and identification for patients in pre-transfusion testing. The incidence of the adverse transfusion reactions and the accordance rate of Rh phenotype-matched transfusion were analyzed retrospectively. A total of 246,340 specimens were detected with Rh blood group antigens D, C, E, c, and e. Rh D antigen was the most common phenotype with a frequency of 99.40%, followed by e antigen, C antigen, c antigen, and E antigen. In Rh D positive specimens, DCe was the most common phenotype, while DCE was the least common. At the same time, in Rh D negative specimens, ce was the most common phenotype with CE and CcE unobserved. Rh phenotype-matched transfusion has been conducted in our department since 2012. The accordance rate of Rh phenotype-matched transfusion has been kept above 95% and the resulting incidence of adverse transfusion reactions has been decreasing year by year, from 19.95‰ in 2011 to 2.21‰ in 2021. Blood transfusion with matched Rh phenotypes was able to avoid the generation of unexpected antibodies, reduce the incidence of adverse transfusion reactions, and enhance precise diagnosis and treatment.

Increasing the Number of Panel Cells for Unexpected Antibody Screening: Is It Economically Worth It?

Increasing the Number of Panel Cells for Unexpected Antibody Screening: Is It Economically Worth It?

Comparison between Screening Cells Including Dia and Mia Antigen for Unexpected Antibody Screening

Comparison between Screening Cells Including Di^a and Mi^a Antigen for Unexpected Antibody Screening

Detection of anti-B antibodies in a patient with A1B blood group: A case report and literature review

ABO antibodies occur naturally and usually exist as alloantibodies. They are the most clinically significant in cases of transfusions. However, there are very few reports on auto-anti-A or B. A 58-year-old man visited our hospital for evaluation of an inguinal mass. Blood typing was performed, while preparing the patient for an excisional biopsy. Forward and reverse typing showed a typical AB and A pattern. Results of the direct antiglobulin and unexpected antibody screening tests were negative. The serum did not react with AB3 cells. The biopsy revealed a diffuse large B-cell lymphoma. After completing four cycles of R-CHOP chemotherapy, the patient achieved complete remission. There were no anti-B antibodies found on repeat ABO typing. This report shares our experience on unexpected anti-B antibody findings in a patient with an A1B blood type. To the best of our knowledge, this is the first report of anti-B antibodies in a patient with an A1B blood type in Korea.

Antibody Screening and Identification in Voluntary Blood Donors – Need of the Hour

Background and Objectives: Although unexpected antibody screening is mandatory according to the Food and Drug Administration and National Blood Policy, the prevalence of irregular red cell antibody and its specificities are not much reported in the donor population of western India. The objective of this study is to find the prevalence of unexpected antibodies in healthy blood donor population of western India. Methods: This is a retrospective study conducted in one of the largest stand-alone blood centers in western India. Data were retrieved from the Integrated Blood Bank Management System (powered by the blood center located in Ahmedabad) software. The data were analyzed for a period of 24 months, from March 1, 2019, to March 31, 2021. Unexpected antibody screening of all voluntary healthy blood donors was performed with fully automated blood grouping equipment Immucor NEO and Diagast EVO using commercial Capture-R Ready Indicator Red Cells (Immucor, USA) and Hemascreen Pool (Diagast, France). Further antibody identification was performed with 11 cell panels. Results: A total of 53,724 volunteer blood donors donated at our blood center during the study period comprised 51,185 (95.27%) male donors and 2539 (4.72%) female donors. A total of 25 (0.046%) donors showed the presence of unexpected antibodies. Most frequent alloantibodies were anti-M (n = 4, 16%) and multiple antibody (n = 4, 16%). Conclusion: Implementation of unexpected antibody screening in all the healthy blood donors routinely and identification of antibodies in antibody screen-positive donors helped us to understand the prevalence of antibodies in our region and its importance in providing compatible blood components which are devoid of irregular antibodies and to avoid delayed transfusion reactions.

The Incidence and Specificity of Unexpected Antibody Using Antibody Screening Test Including Dia and Mia Cell for Korean.

Background: The incidence and distribution of unexpected antibody screening test has been evaluated with Caucasian RBC panel cell. In spite of high incidence of Dia and Mia antigen phenotype in Korea-Mongoloid and south-east population respectively, there has been no documented research on the incidence of anti-Dia and anti-Mia in Korea particularly. To investigate the frequencies and clinical significance of unexpected antibody, screening test including Dia and Mia panel cell was performed.Method: We analyzed the result from 17,664 antibody screening tests performed during recent 30 month period (March 2001–Sep 2003). Antibody screening and identification test are performed using Liss/Coombs gel test with DiaMed-ID system (DiaMed AG, Cressier, Morat, Switzerland) including Dia and Mia panel cell. The incidence of Dia and Mia phenotype was simultaneously evaluated.Results: The incidence of unexpected antibodies was 1.2% (214/17,664). Antibodies that were detected most frequently were anti-Rh (74 patient), followed by anti-Lewis (21 patient) and anti-Dia (15 patients). Out of 6345 patients, 3 anti-Mia (0.047%) were detected. Antibodies of Dia and Mia were IgG specificity and anti-Dia was immune antibody, anti-Mia was mixed with immune and natural antibodies. The frequencies of Dia and Mia phenotye were 12.2% and 0.93% respectively.Conclusion: This study shows that anti-Dia and Mia antibodies are detected frequently for Korean. For safer transfusions, therefore, Dia and Mia panel cell should be also included in antibody screening test for Korean.

Minimum Specimen Volume Analysis of ABO/RhD Typing and Unexpected Antibody Screening Using an Automated Immunohematology System DAYmate S

Minimum Specimen Volume Analysis of ABO/RhD Typing and Unexpected Antibody Screening Using an Automated Immunohematology System DAYmate S

Reduction Plan of 'Undeterminable' in the Unexpected Antibody Screening by the Microcolumn Agglutination Automated Instrument

Reduction Plan of 'Undeterminable' in the Unexpected Antibody Screening by the Microcolumn Agglutination Automated Instrument

Evaluation of the Automated Blood Bank Systems IH-500 and VISION Max for ABO-RhD Blood Typing and Unexpected Antibody Screening

Background: The use of automated systems for pre-transfusion tests is increasing in an attempt to reduce workload and the impact of human errors in blood banks. We evaluated the clinical performance of the automated blood bank systems IH-500 (Bio-Rad Laboratories, Switzerland) and VISION Max (Ortho-...

Correction: Performance Evaluation of Unexpected Antibody Screening Test Including Dia Cell Using 3% Surgiscreen Sub-Code D in Korean Multi-Transfused Patients

Correction: Performance Evaluation of Unexpected Antibody Screening Test Including Di^a Cell Using 3% Surgiscreen Sub-Code D in Korean Multi-Transfused Patients

Performance Evaluation of Unexpected Antibody Screening Test Including DiaCell Using 3% Surgiscreen Sub-Code D in Korean Multi-Transfused Patients

Performance Evaluation of Unexpected Antibody Screening Test Including Di^aCell Using 3% Surgiscreen Sub-Code D in Korean Multi-Transfused Patients

Unexpected Antibody Screening Tests Including Diain Patients with a History of Multiple Packed Red Cell Transfusion

Unexpected Antibody Screening Tests Including Di^ain Patients with a History of Multiple Packed Red Cell Transfusion

Annual Report on External Quality Assessment of Blood Bank Tests in Korea (2013)

We report here the results of surveys for External Quality Assessment (EQA) of blood bank tests carried out in 2013. The proficiency testing specimens were prepared at Ajou University Hospital and sent to 548 and 545 institutes participating in the 1st and 2nd trial, respectively. Test items for the surveys were ABO grouping, RhD typing, crossmatching, direct antiglobulin test (DAT), antibody screening test, and antibody identification test. The response rates for the 1st and 2nd trials were 94.3% and 96.0%, respectively. No answers were considered incorrect answers, and the average accuracy rates of different test items of the survey were as follows: ABO grouping, 98.9% to 100%; RhD typing, 98.4% to 99.2%; crossmatching, 94.4% to 100.0%; DAT using polyspecific reagent, 94.5% to 99.7%; DAT using IgG monospecific reagent, 94.7% to 98.8%; DAT using C3d monospecific reagent, 91.3% to 98.6%; unexpected antibody screening test, 90.9% to 100%; and antibody identification test, 87.3% to 100.0%. Overall, we obtained excellent survey results for the EQA of blood bank tests carried out in 2013, and the number of participating institutes was higher in 2013 than in 2012. (J Lab Med Qual Assur 2014;36:55-63)

Economic and Workflow Analysis of a Blood Bank Automated System

BackgroundThis study compared the estimated costs and times required for ABO/Rh(D) typing and unexpected antibody screening using an automated system and manual methods.MethodsThe total cost included direct and labor costs. Labor costs were calculated on the basis of the average operator salaries and unit values (minutes), which was the hands-on time required to test one sample. To estimate unit values, workflows were recorded on video, and the time required for each process was analyzed separately.ResultsThe unit values of ABO/Rh(D) typing using the manual method were 5.65 and 8.1 min during regular and unsocial working hours, respectively. The unit value was less than 3.5 min when several samples were tested simultaneously. The unit value for unexpected antibody screening was 2.6 min. The unit values using the automated method for ABO/Rh(D) typing, unexpected antibody screening, and both simultaneously were all 1.5 min. The total cost of ABO/Rh(D) typing of only one sample using the automated analyzer was lower than that of testing only one sample using the manual technique but higher than that of testing several samples simultaneously. The total cost of unexpected antibody screening using an automated analyzer was less than that using the manual method.ConclusionsABO/Rh(D) typing using an automated analyzer incurs a lower unit value and cost than that using the manual technique when only one sample is tested at a time. Unexpected antibody screening using an automated analyzer always incurs a lower unit value and cost than that using the manual technique.

External quality assessment in blood group serology in the World Health Organization South-East Asia Region.

The quality of blood transfusion services (BTS) is essential for the treatment of patients who need blood or blood products. BTS involve several steps, including the acquisition of the donor's blood, blood grouping, unexpected antibody screening, blood storage, transfusion, etc. There is a need to check the effectiveness of all elements in the BTS can be assessed and monitored by an external quality assessment. To assess and evaluate the performance of ABO and Rh(D) blood grouping and unexpected antibody screening of the selected World Health Organization (WHO) South-East Asia Region Member country laboratories. WHO Collaborating Centre on Strengthening Quality of Health Laboratories (Thailand) organized a regional external quality assessment scheme for blood group serology (REQAS-BGS) between 2002 and 2008 for laboratories in countries of the WHO South-East Asia Region. Test items for ABO and Rh(D) blood groupings and unexpected antibody screening and identification were distributed three cycles per year to BTS laboratories in Bangladesh, Bhutan, India, Indonesia, Maldives, Myanmar, Nepal, Sri Lanka and Thailand. By the end of the project, a total of 20 BTS laboratories had participated for differing lengths of time. It was found that 87.5%, 93.3%, 81.3%, 92.3%, 100% and 87.5% of laboratories returned the test results in 2002, 2003, 2004, 2006, 2007 and 2008, respectively. Laboratories with excellent quality or a trend of quality improvement for ABO and Rh(D) blood grouping, unexpected antibody screening and identification during the six years were 60% (12/20), 50% (10/20), 52.9% (9/17) and 81.8% (9/11), respectively. At the initiation of the scheme, most laboratories were using substandard methods for ABO and Rh blood groupings, i.e. performing only direct blood grouping alone but subsequently adopted the standard methods, i.e. performing both direct and reverse blood groupings. REQAS-BGS in South-East Asia countries has been useful for assessing, monitoring and improving the quality of testing. Challenges such as high costs and regulatory requirements for international shipment of blood samples could be solved by amending the regulation(s) for shipment, or establishing a national EQAS.

A case of acute hemolytic transfusion reaction due to anti-Diaantibody -A case report-

Many medical institutions in Korea have recently been performing an antibody screening test as one of the essential elements of a pre-transfusion test. The Dia antigen is well known as one of the antigens with low incidence among Caucasians; however, it has been discovered with a relatively higher incidence among Mongoloid populations. The frequency of the Dia antigen among the Korean population is estimated to be 6.4-14.5%. But in Korea, a screening panel of cells from abroad without Dia positive cells has been commonly used when a patient has an unexpected antibody screening test. Here we report a case of acute hemolytic transfusion reaction due to Anti-Dia antibody. To prevent other transfusion reaction by anti-Dia antibody, addition of Dia positive cells as unexpected antibody screening test is recommended.

Evaluation of Two Automated Instruments for Pre-transfusion Testing: AutoVue Innova and Techno TwinStation

Despite the advances in total laboratory automation, a considerable amount of work in blood banks is still done using outdated manual methods. Some automated pre-transfusion testing instruments have recently been developed. Of these, we evaluated and compared the AutoVue Innova (Ortho, USA) and the Techno TwinStation (DiaMed AG, Switzerland). Forward and reverse ABO/Rh typing and unexpected antibody screening and identification tests were performed on 4,628 samples using the manual method and the two automated instruments. Two different anticoagulants (EDTA and citrate) were compared in ABO/Rh typing and unexpected antibody screening tests. Titrating studies were conducted on the following 7 dilutions using 5 samples of irregular antibodies with anti-E, anti-E & -c, anti-D, and anti-Le(a) with anti-Fy(a): 1:2, 1:4, 1:8, 1:16, 1:32, 1:64, and 1:128. The test throughput per hour, the time required to perform 1 and 100 tests, and a simulation test for total events occurring in 1 day were also measured. No erroneous results were reported between the two instruments and the manual method. Discrepancies observed in 10 cases (0.4%) of ABO/Rh typing were of higher intensity with AutoVue Innova than with the manual method. AutoVue Innova exhibited the highest sensitivity in the titrating study and throughput performance compared with the manual method and the Techno TwinStation. Especially in the throughput and time required to complete 100 antibody screening tests, AutoVue Innova had a 3.3- and 3.5-fold higher performance, respectively, than Techno TwinStation. Because both of the two fully automated instruments (AutoVue Innova and Techno TwinStation) had high levels of accuracy and performance, it is expected that use of fully automated instruments will reduce human labor, turnaround time, and operator error in the blood bank.

冷式抗体保有患者への輸血用血液の選択時に冷式抗体を無視することの当否

In patients with cold-reactive antibodies (CRAbs) undergoing transfusion no consensus has yet been reached as to whether or not the corresponding antigen-negative red blood cells (RBC) should be selected.In our hospital, we routinely perform unexpected antibody screening tests by the saline method (S), bromelin technique (Br) and indirect anti-globulin testing (IAT). Of 401 unexpected antibodies detected between January 1995 and June 1996, 263 (66%) were CRAbs. Of these 213 CRAbs (81.0%) were not reactive in IAT with IgG-specific antisera (IAT-IgG) or at 37°C. Among patients with CRAbs, 172 were corns-matched with Br at 37°C regardless of CRAbs. Of these, 27 were transfused with 255 units of RBC compatible with the corresponding antigens; and 11 patients with anti-Lea, 16 with anti-Leb, 10 with anti-P1 and 1 with anti-M were transfused 25, 181, 47 and 2 units of antigen-positive RBC, respectively. None of these patients exhibited increaed levels of antibodies or developed transfusion reactions.Over the past six and a half years, further more, 17 other cold-reactive anti-Lea-positive patients given Le(a+) RBC were followed to examine antibody levels, and 71 cold-reactive anti-Lea-positive patients transfused with Le(a+) RBC were observed with respect to clinical course without monitoring of antibody titers. None of these patients showed any increase in antibody values or transfusion reactions.We conclude that antibodies non-reactive at 37°C and/or IAT-IgG are of no clinical significance and can be ignored in transfusion testing.