1. bookVolume 36 (2020): Issue 1 (March 2020)
Journal Details
Format
Journal
eISSN
1930-3955
First Published
01 Sep 1984
Publication timeframe
4 times per year
Languages
English
access type Requires Authentication

A prospective, observational study for optimization of antibody screening in pretransfusion compatibility testing

Published Online: 17 Feb 2021
Volume & Issue: Volume 36 (2020) - Issue 1 (March 2020)
Page range: 19 - 28
Journal Details
Format
Journal
eISSN
1930-3955
First Published
01 Sep 1984
Publication timeframe
4 times per year
Languages
English
Abstract

Despite known use of antibody screening (AS), it has not been adopted uniformly across blood centers in India. Many centers in India are currently using a type and hold policy with subsequent antihuman globulin (AHG) crossmatch when blood units are requested. The main aim of this study was to assess the benefits of a type and screen (TS) policy in which blood grouping and AS are performed simultaneously during the first hospital visit. If the AS is negative, subsequent requests for blood units would require an immediate spin test (IST) crossmatch with release of blood units, followed by an AHG crossmatch. This prospective, observational study was conducted at a tertiary health care center between July 2014 and December 2018 and included only Indian patients. Blood grouping and AS were performed during the first hospital visit on a total of 22,888 patients; the majority of patients were from hemato-oncology and blood marrow transplant, hepatology and liver transplant, cardiothoracic vascular surgery, and medical intensive care units. Demographic parameters were evaluated for risk of alloimmunization, and a record of the same was maintained. Depending on the AS results, a further course of action was chosen. Clinically significant alloantibodies were detected in 145 patients, and autoantibodies were detected in 53 patients. Alloantibodies were mainly against Rh and Kell blood group antigens. A significantly higher proportion of patients in the AS+ group required blood transfusion when compared with the AS– group. In cases wherein the IST crossmatch was compatible but AHG crossmatch was not, follow-up did not demonstrate any clinical or laboratory evidence of hemolysis. AS is a safe, efficient, and beneficial tool for pretransfusion compatibility testing in both AS+ and AS– patients. With a TS policy, AHG crossmatch can be omitted in AS–e patients without compromising safety.

Keywords

Garratty G. The role of compatibility tests. Transfusion 1982;22:169–72. Garratty G. The role of compatibility tests . Transfusion 1982 ; 22 : 169 72 . 10.1046/j.1537-2995.1982.22282177132.x6803410 Search in Google Scholar

Office of Biologics Research and Review, National Center for Drugs and Biologics, United States. Equivalent methods for compatibility testing: memorandum to blood establishments. Washington, DC: Food and Drug Administration, 1984. Office of Biologics Research and Review, National Center for Drugs and Biologics, United States . Equivalent methods for compatibility testing: memorandum to blood establishments . Washington, DC : Food and Drug Administration , 1984 . Search in Google Scholar

AABB. Standards for blood banks and transfusion services, 31st ed. Bethesda, MD: AABB, 2018. AABB . Standards for blood banks and transfusion services , 31st ed. Bethesda, MD : AABB , 2018 . Search in Google Scholar

Chow EY. The impact of the type and screen test policy on hospital transfusion practice. Hong Kong Med J 1999;5:275–9. Chow EY. The impact of the type and screen test policy on hospital transfusion practice . Hong Kong Med J 1999 ; 5 : 275 9 . Search in Google Scholar

Cordle DG, Strauss RG, Snyder EL, Floss AM. Safety and cost-containment data that advocate abbreviated pretransfusion testing. Am J Clin Pathol 1990;94:428–31. Cordle DG Strauss RG Snyder EL Floss AM. Safety and cost-containment data that advocate abbreviated pretransfusion testing . Am J Clin Pathol 1990 ; 94 : 428 31 . 10.1093/ajcp/94.4.4282220670 Search in Google Scholar

Heddle NM, O’Hoski P, Singer J, McBride JA, Ali MA, Kelton JG. A prospective study to determine the safety of omitting the antiglobulin crossmatch from pretransfusion testing. Br J Haematol 1992;81:579–84. Heddle NM O’Hoski P Singer J McBride JA Ali MA Kelton JG. A prospective study to determine the safety of omitting the antiglobulin crossmatch from pretransfusion testing . Br J Haematol 1992 ; 81 : 579 84 . 10.1111/j.1365-2141.1992.tb02995.x1390245 Search in Google Scholar

Fung MK, Eder AF, Spitalnik SL, Westhoff CM, Eds. Technical manual. 19th ed. Bethesda, MD: AABB Press, 2017. Fung MK Eder AF Spitalnik SL Westhoff CM , Eds. Technical manual . 19th ed. Bethesda, MD : AABB Press , 2017 . Search in Google Scholar

Oberman HA, Barnes BA, Friedman BA. The risk of abbreviating the major crossmatch in urgent or massive transfusion. Transfusion 1978;18:137–41. Oberman HA Barnes BA Friedman BA. The risk of abbreviating the major crossmatch in urgent or massive transfusion . Transfusion 1978 ; 18 : 137 41 . 10.1046/j.1537-2995.1978.18278160574.x417431 Search in Google Scholar

Marosszeky S, McDonald S, Sutherland J, et al. Suitability of preadmission blood samples for pretransfusion testing in elective surgery. Transfusion 1997;37:910–2. Marosszeky S McDonald S Sutherland J , Suitability of preadmission blood samples for pretransfusion testing in elective surgery . Transfusion 1997 ; 37 : 910 2 . 10.1046/j.1537-2995.1997.37997454016.x9308636 Search in Google Scholar

Hoeltge GA, Domen RE, Rybicki LA, Schaffer PA. Multiple red cell transfusions and alloimmunization: experience with 6996 antibodies detected in a total of 159,262 patients from 1985 to 1993. Arch Pathol Lab Med 1995;119:42–5. Hoeltge GA Domen RE Rybicki LA Schaffer PA. Multiple red cell transfusions and alloimmunization: experience with 6996 antibodies detected in a total of 159,262 patients from 1985 to 1993 . Arch Pathol Lab Med 1995 ; 119 : 42 5 . Search in Google Scholar

Chow EY. The impact of the type and screen test policy on hospital transfusion practice. Hong Kong Med J 1999;5:275–9. Chow EY. The impact of the type and screen test policy on hospital transfusion practice . Hong Kong Med J 1999 ; 5 : 275 9 . Search in Google Scholar

Zeerleder S. Autoimmune haemolytic anaemia: a practical guide to cope with a diagnostic and therapeutic challenge. Neth J Med 2011;69:177–84. Zeerleder S. Autoimmune haemolytic anaemia: a practical guide to cope with a diagnostic and therapeutic challenge . Neth J Med 2011 ; 69 : 177 84 . Search in Google Scholar

Uthemann H, Poschmann A. Solid-phase antiglobulin test for screening and identification of red cell antibodies. Transfusion 1990;30:114–6. Uthemann H Poschmann A. Solid-phase antiglobulin test for screening and identification of red cell antibodies . Transfusion 1990 ; 30 : 114 6 . 10.1046/j.1537-2995.1990.30290162895.x2305439 Search in Google Scholar

Agrawal A. Type and screen policy: is there any compromise on blood safety? Transfus Apher Sci 2014;50:271–3. Agrawal A. Type and screen policy: is there any compromise on blood safety? Transfus Apher Sci 2014 ; 50 : 271 3 . 10.1016/j.transci.2014.01.00324472664 Search in Google Scholar

Pathak S, Chandrashekhar M, Wankhede GR. Type and screen policy in the blood bank: is AHG cross-match still required? A study at a multispecialty corporate hospital in India. Asian J Transfus Sci 2011;5:153–6. Pathak S Chandrashekhar M Wankhede GR. Type and screen policy in the blood bank: is AHG cross-match still required? A study at a multispecialty corporate hospital in India . Asian J Transfus Sci 2011 ; 5 : 153 6 . 10.4103/0973-6247.83242315924621897595 Search in Google Scholar

Chaudhary R, Agarwal N. Safety of type and screen method compared to conventional antiglobulin crossmatch procedures for compatibility testing in Indian setting. Asian J Transfus Sci 2011;5:157. Chaudhary R Agarwal N. Safety of type and screen method compared to conventional antiglobulin crossmatch procedures for compatibility testing in Indian setting . Asian J Transfus Sci 2011 ; 5 : 157 . 10.4103/0973-6247.83243315924721897596 Search in Google Scholar

Tiwari AK, Aggarwal G, Dara RC, Arora D, Gupta GK, Raina V. First Indian study to establish safety of immediate-spin crossmatch for red blood cell transfusion in antibody screen–negative recipients. Asian J Transfus Sci 2017;11:40–4. Tiwari AK Aggarwal G Dara RC Arora D Gupta GK Raina V. First Indian study to establish safety of immediate-spin crossmatch for red blood cell transfusion in antibody screen–negative recipients . Asian J Transfus Sci 2017 ; 11 : 40 4 . 10.4103/0973-6247.200774534527928316439 Search in Google Scholar

Milkins C, Berryma J, Cantwell C, et al. Guidelines for pretransfusion compatibility procedures in blood transfusion laboratories. Transfus Med 2013;23:3–35. Milkins C Berryma J Cantwell C , Guidelines for pretransfusion compatibility procedures in blood transfusion laboratories . Transfus Med 2013 ; 23 : 3 35 . 10.1111/j.1365-3148.2012.01199.x Search in Google Scholar

Aggarwal G, Tiwari AK, Arora D, et al. Advantages of type and screen policy: perspective from a developing country! Asian J Transfus Sci 2018;12:42–5. Aggarwal G Tiwari AK Arora D , Advantages of type and screen policy: perspective from a developing country! Asian J Transfus Sci 2018 ; 12 : 42 5 . 10.4103/ajts.AJTS_31_17 Search in Google Scholar

Cheng CK, Lee CK, Lin CK. Clinically significant red blood cell antibodies in chronically transfused patients: a survey of Chinese thalassemia major patients and literature review. Transfusion 2012;52:2220–4. Cheng CK Lee CK Lin CK. Clinically significant red blood cell antibodies in chronically transfused patients: a survey of Chinese thalassemia major patients and literature review . Transfusion 2012 ; 52 : 2220 4 . 10.1111/j.1537-2995.2012.03570.x Search in Google Scholar

Moise KJ Jr. Non-anti-D antibodies in red-cell alloimmunization. Eur J Obstet Gynecol Reprod Biol 2000;92:75–81. Moise KJ Jr. Non-anti-D antibodies in red-cell alloimmunization . Eur J Obstet Gynecol Reprod Biol 2000 ; 92 : 75 81 . 10.1016/S0301-2115(00)00428-0 Search in Google Scholar

Chou ST, Jackson T, Vege S, Smith-Whitley K, Friedman DF, Westhoff CM. High prevalence of red blood cell alloimmunization in sickle cell disease despite transfusion from Rh-matched minority donors. Blood 2013;122:1062–71. Chou ST Jackson T Vege S Smith-Whitley K Friedman DF Westhoff CM. High prevalence of red blood cell alloimmunization in sickle cell disease despite transfusion from Rh-matched minority donors . Blood 2013 ; 122 : 1062 71 . 10.1182/blood-2013-03-49062323723452 Search in Google Scholar

Tiwari AK, Pandey P, Sharma J, Shailja K, Dixit S, Raina V. Incidence of clinically significant antibodies in patients and healthy blood donors: a prospective cross-sectional study from a tertiary healthcare center in India. Transfus Apher Sci 2014;50:230–4. Tiwari AK Pandey P Sharma J Shailja K Dixit S Raina V. Incidence of clinically significant antibodies in patients and healthy blood donors: a prospective cross-sectional study from a tertiary healthcare center in India . Transfus Apher Sci 2014 ; 50 : 230 4 . 10.1016/j.transci.2013.08.00824548676 Search in Google Scholar

Pahuja S, Gupta SK, Pujani M, Jain M. The prevalence of irregular erythrocyte antibodies among antenatal women in Delhi. Blood Transfus 2011;9:388. Pahuja S Gupta SK Pujani M Jain M. The prevalence of irregular erythrocyte antibodies among antenatal women in Delhi . Blood Transfus 2011 ; 9 : 388 . Search in Google Scholar

LaSalle-Williams M, Nuss R, Le T, et al. Extended red blood cell antigen matching for transfusions in sickle cell disease: a review of a 14-year experience from a single center (CME). Transfusion 2011;51:1732–9. LaSalle-Williams M Nuss R Le T , Extended red blood cell antigen matching for transfusions in sickle cell disease: a review of a 14-year experience from a single center (CME) . Transfusion 2011 ; 51 : 1732 9 . 10.1111/j.1537-2995.2010.03045.x21332724 Search in Google Scholar

Vichinsky EP, Luban NL, Wright E, et al. Prospective RBC phenotype matching in a stroke-prevention trial in sickle cell anemia: a multicenter transfusion trial. Transfusion 2001;41:1086–92. Vichinsky EP Luban NL Wright E , Prospective RBC phenotype matching in a stroke-prevention trial in sickle cell anemia: a multicenter transfusion trial . Transfusion 2001 ; 41 : 1086 92 . 10.1046/j.1537-2995.2001.41091086.x11552063 Search in Google Scholar

Castro O, Sandler SG, Houston-Yu P, Rana S. Predicting the effect of transfusing only phenotype-matched RBCs to patients with sickle cell disease: theoretical and practical implications. Transfusion 2002;42:684–90. Castro O Sandler SG Houston-Yu P Rana S. Predicting the effect of transfusing only phenotype-matched RBCs to patients with sickle cell disease: theoretical and practical implications . Transfusion 2002 ; 42 : 684 90 . 10.1046/j.1537-2995.2002.00126.x12147019 Search in Google Scholar

Fasano RM, Chou ST. Red blood cell antigen genotyping for sickle cell disease, thalassemia, and other transfusion complications. Transfus Med Rev 2016;30:197–201. Fasano RM Chou ST. Red blood cell antigen genotyping for sickle cell disease, thalassemia, and other transfusion complications . Transfus Med Rev 2016 ; 30 : 197 201 . 10.1016/j.tmrv.2016.05.01127345938 Search in Google Scholar

Gogri H, Kulkarni S, Vasantha K, Jadhav S, Ghosh K, Gorakshakar A. Partial matching of blood group antigens to reduce alloimmunization in Western India. Transfus Apher Sci 2016;54:390–5. Gogri H Kulkarni S Vasantha K Jadhav S Ghosh K Gorakshakar A. Partial matching of blood group antigens to reduce alloimmunization in Western India . Transfus Apher Sci 2016 ; 54 : 390 5 . 10.1016/j.transci.2016.02.00227020262 Search in Google Scholar

Pal M, Williams B. Prevalence of maternal red cell alloimmunisation: a population study from Queensland, Australia. Pathology 2015;47:151–5. Pal M Williams B. Prevalence of maternal red cell alloimmunisation: a population study from Queensland, Australia . Pathology 2015 ; 47 : 151 5 . 10.1097/PAT.000000000000022525551305 Search in Google Scholar

Elhence P, Solanki A, Verma A. Red blood cell antibodies in thalassemia patients in northern India: risk factors and literature review. Indian J Hematol Blood Transfus 2014;30:301–8. Elhence P Solanki A Verma A. Red blood cell antibodies in thalassemia patients in northern India: risk factors and literature review . Indian J Hematol Blood Transfus 2014 ; 30 : 301 8 . 10.1007/s12288-013-0311-y424340225435732 Search in Google Scholar

Karimi M, Nikrooz P, Kashef S, Jamalian N, Davatolhagh ZR. RBC alloimmunization in blood transfusion-dependent β-thalassemia patients in southern Iran. Int J Lab Hematol 2007;29:321–6. Karimi M Nikrooz P Kashef S Jamalian N Davatolhagh ZR. RBC alloimmunization in blood transfusion-dependent β-thalassemia patients in southern Iran . Int J Lab Hematol 2007 ; 29 : 321 6 . 10.1111/j.1365-2257.2006.00856.x17824911 Search in Google Scholar

Agrawal A, Mathur A, Dontula S, Jagannathan L. Red blood cell alloimmunization in multi-transfused patients: a bicentric study in India. Glob J Transfus Med 2016;1:12. Agrawal A Mathur A Dontula S Jagannathan L. Red blood cell alloimmunization in multi-transfused patients: a bicentric study in India . Glob J Transfus Med 2016 ; 1 : 12 . 10.4103/2455-8893.178005 Search in Google Scholar

Zaman S, Chaurasia R, Chatterjee K, Thapliyal RM. Prevalence and specificity of RBC alloantibodies in Indian patients attending a tertiary care hospital. Adv Hematol 2014; 2014:749218. Zaman S Chaurasia R Chatterjee K Thapliyal RM. Prevalence and specificity of RBC alloantibodies in Indian patients attending a tertiary care hospital . Adv Hematol 2014 ; 2014 : 749218 . 10.1155/2014/749218421668925386192 Search in Google Scholar

Ho HK, Ha SY, Lam CK, et al. Alloimmunization in Hong Kong southern Chinese transfusion-dependent thalassemia patients. Blood 2001;97:3999–4000. Ho HK Ha SY Lam CK , Alloimmunization in Hong Kong southern Chinese transfusion-dependent thalassemia patients . Blood 2001 ; 97 : 3999 4000 . 10.1182/blood.V97.12.3999 Search in Google Scholar

Bhagwat SN, Sharma JH, Jose J, Modi CJ. Comparison between conventional and automated techniques for blood grouping and crossmatching: experience from a tertiary care centre. J Lab Physicians 2015;7:96. Bhagwat SN Sharma JH Jose J Modi CJ. Comparison between conventional and automated techniques for blood grouping and crossmatching: experience from a tertiary care centre . J Lab Physicians 2015 ; 7 : 96 . 10.4103/0974-2727.163130455963626417159 Search in Google Scholar

Nathalang O, Chuansumrit A, Prayoonwiwat W, Siripoonya P, Sriphaisal T. Comparison between the conventional tube technique and the gel technique in direct antiglobulin tests. Vox Sang 1997;72:169–71. Nathalang O Chuansumrit A Prayoonwiwat W Siripoonya P Sriphaisal T. Comparison between the conventional tube technique and the gel technique in direct antiglobulin tests . Vox Sang 1997 ; 72 : 169 71 . 10.1159/000461985 Search in Google Scholar

Das SS, Chaudhary R, Khetan D. A comparison of conventional tube test and gel technique in evaluation of direct antiglobulin test. Hematology 2007;12:175–8. Das SS Chaudhary R Khetan D. A comparison of conventional tube test and gel technique in evaluation of direct antiglobulin test . Hematology 2007 ; 12 : 175 8 . 10.1080/1024533060111186217454201 Search in Google Scholar

Novaretti MC, Jens E, Pagliarini T, Bonifacio SL, Dorlhiac–Llacer PE, Chamone DA. Comparison of conventional tube test technique and gel microcolumn assay for direct antiglobulin test: a large study. J Clin Lab Anal 2004;18:255–8. Novaretti MC Jens E Pagliarini T Bonifacio SL Dorlhiac–Llacer PE Chamone DA. Comparison of conventional tube test technique and gel microcolumn assay for direct antiglobulin test: a large study . J Clin Lab Anal 2004 ; 18 : 255 8 . 10.1002/jcla.20033680770915356874 Search in Google Scholar

Weisbach V, Kohnhäuser T, Zimmermann R, et al. Comparison of the performance of microtube column systems and solid-phase systems and the tube low-ionic-strength solution additive indirect antiglobulin test in the detection of red cell alloantibodies. Transfus Med 2006;16:276–84. Weisbach V Kohnhäuser T Zimmermann R , Comparison of the performance of microtube column systems and solid-phase systems and the tube low-ionic-strength solution additive indirect antiglobulin test in the detection of red cell alloantibodies . Transfus Med 2006 ; 16 : 276 84 . 10.1111/j.1365-3148.2006.00674.x16879156 Search in Google Scholar

Bajpai M, Kaur R, Gupta E. Automation in immunohematology. Asian J Transfus Sci 2012;6:140. Bajpai M Kaur R Gupta E. Automation in immunohematology . Asian J Transfus Sci 2012 ; 6 : 140 . 10.4103/0973-6247.98914343975222988378 Search in Google Scholar

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