Detection and analysis of two drug-induced antibodies in suspicious blood samples from pre-transfusion compatibility tests / 中国输血杂志

【Objective】 To detect the piperacillin and amoxicillin antibodies in suspicious blood samples from pre-transfusion compatibility tests in Wuxi and analyze the general characteristics of them, so as to eliminate the interference of drug-induced antibodies with compatibility tests and provide reference for safe and effective blood transfusion, 【Methods】 Drug-sensitized RBCs and low-ion anti-globulin microcolumn gels were used to detect piperacillin and amoxicillin antibodies in 128 plasma samples which were initially undetermined in pre-transfusion compatibility tests. Data were analyzed by Chi-square test or fisher′s exact test. P<0.05 was statistically significant. 【Results】 Among these 128 undetermined samples, including 31 cases of type A, 48 type B, 14 type AB and 35 type O, the overall positive rate of piperacillin and amoxicillin antibodies was 28.9%(37/128), in which the positive rates of piperacillin and amoxicillin antibodies were 20.3%(26/128) and 8.6%(11/128), respectively. The difference between these two drug-induced antibodies was significant(P<0.05). Further analysis showed that the piperacillin antibodies in patients over 50 years old was 25.3%(24/95), while under 50 years old was 6.1%(2/33)(P<0.05). In contrast, the amoxicillin antibodies in patients over 50 years old was 5.3%(5/95), while under 50 years old was 18.2%(6/33), with statistically significant differences between each other(P<0.05). 【Conclusions】 In patients with suspicious antibodies in pre-transfusion detection, except for the allotype antibodies, drug-induced antibodies should be more considered in combination with medication history to better ensure the safety and effectiveness of blood transfusion.

Study of two methods for three hemolytic tests of hemolytic disease of newborn / 中国基层医药

Objective To compare and anlyze the applications of microcolumn gel test (MGT)and the tube anti -globulin test (TAT)for detection of three hemolytic tests.Methods Microcolumn gel test and tube anti -globulin test were used in three tests with a total of 160 cases of blood speciments of newborn who had blood group in-compatibility with their mothers:direct anti -globulin test,free test and elution test,then the data were analyzed statis-tically.Results The positive rates of direct anti -globulin test of MGT and TAT were 30.0% and 12.5%(χ2 =14.64,P <0.05);The positive rates of free test of MGT and TAT were 47.5% and 25.0%(χ2 =17.53,P <0.05), respectively;The positive rates of elution test of MGT and TAT were 62.5% and 30.0%(χ2 =33.99,P <0.05). There was statistically significant difference between two methods in three tests.Conclusion MGT has the advantages of quickness,simplicity,high sensitivity,convenience,needs less sample,high repeatability,direct judging of the re-sults,which is better than TAT in three hemolytic tests.

Application of 3 kinds of method of blood crossmatching in neonatal blood transfusion security / 国际检验医学杂志

Objective To investigate the application values of 3 kinds of crossmatching method saline medium method,polybrene test and microcolumn gel test in the neonatal blood transfusion security.Methods 174 newborns needing blood transfusion were simultaneously performed the isotype crossmatching by the saline method,polybrene test and microcolumn gel test.The irregular antibody and the direct antiglobulin test were routinely conducted,the samples with positive irregular antibody were further per-formed the antibody specificity identification.Results 14 cases (8.05%)of crossmatching incompatibility were found by the saline method,1 case (0.57%)by the polybrene test and 62 cases (35.63%)by the microcolumn gel test;among which,31 cases were secondary side crossmatching incompatibility caused by positive direct antiglobulin test,1 was the incompatibility of 3 methods caused by anti-D antibodies.The difference between the polybrene test and the microcolumn gel test was of statistical significance (P <0.05).Conclusion The blood crossmatching by the microcolumn gel test in blood transfusion of newborns requires quite few amount of blood sample,is simple to operate and easy to be standardized.With results clearly and easily measured and sensitivity higher than that of polybrene test,its result is clear and easy to be judged,its sensitivity is higher than that of the polybrene test, which has the important significance for ensuring the neonatal blood transfusion safety.

Comparation of microcolumn gel test and tube anti -globulin test with IgG anti A (B)of pregnant women / 中国基层医药

Objective Compared study on microcolumn gel test (MGT)and tube anti -globulin test (TAT) in the detection of pregnant women IgG anti A (B)in the application of antibody and evaluate the application value of MGT in the prediction of HDN.Methods Choosed blood samples of 443 cases of O blood type pregnant women whose husband were not O blood type as the research object.Every specimen were tested by MGT method and TAT method,and the data were treated statistically.Results The positive rate of MGT method and TAT method were:30% and 12.5% which had statistical significance(χ2 =15.95,P <0.05).The difference was significant in positive cases titer distribution(t =15.13,P <0.01).Conclusion The micro column gel method is rapid,simple,sensitive and repeatable compared of tube anti -globulin test (TAT).

Comparison of two methods for testing anti-ABO IgG anibody titer in pregnant women / 国际检验医学杂志

Objective To compare the 2 methods of the flow cytometry and the microcolumn gel agglutination assay for testing anti-ABO Ig G antibody.Methods The flow cytometry and the microcolumn gel agglutination assay were adopted to detect the an-ti-ABO IgG antibody in the O blood type pregnant women(experimental group)and the A/B blood type pregnant women (control group).The difference in the positive rates between the experimental and control groups and the correlation between these two methods were analysed.The different titers of samples were selected for detection on different days to compare their reproducibili-ty.Results 300 samples from the experimental goup and 300 samples from the control group were collected.The detection results of 2 methods showed that the positive rates of the experimental group was significantly higher than that of the control group with statistical difference(P <0.05).The correlation coefficients(rs )between these two methods were 0.694.The coefficient of variation in the flow cytometry was smaller than that in the microcolumn gel agglutination assay(P <0.05).Conclusion ABO blood type in-compatibility is more common in O type pregnant women.The flow cytometry and the microcolumn gel agglutination assay possess good correlation.The reproducibility of the flow cytometry is better than that of microcolumn gel agglutination assay.

Use of Staphylococcal Protein-A and Streptococcal Protein-G for Detection of Red Blood Cells (RBC) Antibodies and Comparison with Other Techniques.

Background: Detection of red blood cells antibodies is important for the diagnosis of autoimmune hemolytic anemia, hemolytic disease of newborn, pre-transfusion testing and other problems. The aim of this study was to use Staphylococcal protein A (SpA) and Streptococcal protein G (SpG) as reagents in immunological tests for detecting red blood cells (RBC) antibodies and to compare the method with other techniques. Study Design & Methods: Sera from 60 patients, comprising forty-four anti-D positive sera from pregnant women and 16 from healthy controls were, used for the study. The anti-globulin gel test and the standard Coombs’ test were used to determine RBC antibodies in these sera and the result were compared with that of protein A and protein G tests. Results: With various degree of agglutination all 4 techniques detected the presence of RBC antibodies (anti-D) in the sera from 44 pregnant women, and tested negative for the remaining 16 sera (from healthy controls). The sensitivity and the specificity of the 4 techniques was 100%. Conclusions: This preliminary study demonstrates that both SpA and SpG tests can be used for the detection of RBC antibodies and therefore requires more study and testing before they can become useful standard tests in transfusion medicine.

Screening and Identification of Unexpected Red Cell Antibodies by Simultaneous LISS/Coombs and NaCl/Enzyme Gel Methods

We evaluated the clinical usefulness of simultaneous LISS/Coombs and NaCl/Enzyme testing using the gel method for screening and identification of unexpected antibodies in 15,014 samples. When unexpected antibodies were detected by either screening test, those antibodies were identified using both the LISS/Coombs and the NaCl/Enzyme gel test. The positive screening rates of the LISS/Coombs, NaCl/Enzyme, and combined tests (excluding 25 autoantibody cases) were 0.48%, 1.29%, and 1.39%, respectively. Among the 57 samples positive by both screening methods, the antibodies in 19.3% could be identified only by the NaCl/Enzyme method. Among the 137 samples positive only by NaCl/Enzyme screening, 74.5% showed positive results in antibody identification only by the NaCl/Enzyme test, although 7.3% were also positive in the LISS/Coombs test. The NaCl/Enzyme method thus showed about threefold higher detection rates than the LISS/Coombs method, especially in screening for Rh antibodies, and higher exact identification rates and discriminatory power for identifying mixed antibodies. Addition of the NaCl/Enzyme method to routine laboratory procedures may detect and identify considerable numbers of significant antibodies that might be missed if only the LISS/Coombs method is used.

Evaluation of the Performance of the DG Gel Test for Unexpected Antibody Screening and Identification / 대한수혈학회지

BACKGROUND: There is a recent trend of increased use of the gel test for detecting unexpected antibodies because of its simplicity and the ease with which a definitive interpretation can be made. The aim of the present study was to evaluate the diagnostic performance of newly developed DG Gel microtube column agglutination system as compared with the tube method and other two microtube column agglutination systems (DiaMed-ID, Ortho BioVue). METHODS: We collected 305 patients who were screened for unexpected antibody from February to July 2007. These samples were screened and we identified the unexpected antibody with the tube method and three microtube column agglutination systems. RESULTS: The highest estimated sensitivity of the screening test was 97.4% for DiaMed-ID. The highest estimated specificity of the screening test was 100% for DG Gel. The least number of discordant identification results was seven for the DG Gel. CONCLUSION: DG Gel has good diagnostic efficacy and accuracy for identifying unexpected antibody. DG Gel might be used as a replacement or supplement for the previous tests.

Usefulness of NaCl/Enzyme Gel Test for the Identification of Unexpected Antibodies / 대한진단검사의학회지

BACKGROUND: The microcolumn assay technique offers significant advances in identification of unexpected antibodies; however, some erythrocyte antibodies still remain unidentified. To see if NaCl/Enzyme test is useful for the identification of antibodies, we compared the LISS/Coombs and NaCl/Enzyme tests for identification rates, and investigated an association between the frequency of each antibody and a history of transfusion or gestation. METHODS: From June 2004 to June 2005, antibody screening tests were carried out on 5,517 patients using the LISS/Coombs gel test (DiaMed AG, Switzerland). When antibodies were detected, antibody identification tests were carried out with the LISS/Coombs and NaCl/Enzyme gel tests (DiaMed AG) simultaneously. RESULTS: Unexpected antibodies were detected in 79 patients (1.43%). These antibodies were identified in 39 (49.4%), 59 (74.7%), and 68 patients (86.1%) by the LISS/Coombs test, the NaCl/Enzyme test, and the two tests combined, respectively. With the addition of the NaCl/ Enzyme test, unexpected antibodies were further identified in 29 cases (anti-Lewis, 14; anti-Rhesus, 13; and anti-P1, 2). On the other hand, 9 cases (anti-M, 5; anti-Fy(b), 3; and anti-N, 1) were identified by the LISS/Coombs test only. Of the unexpected antibodies found in patients without a previous history of transfusion or gestation, anti-Lewis (50.0%, 10/20) was the most common, while in patients with the history anti-Rhesus (48.1%, 26/54) was the most frequent. CONCLUSIONS: The NaCl/Enzyme combined with LISS/Coombs gel test was useful for the identification of unexpected antibodies, and antibodies found in patients without a previous history of transfusion or gestation were clinically less relevant than those found in patients with the history.

Comparison of four methods for determination of IgG red blood cell antibodies / 第三军医大学学报

Objective To compare the specificity, sensitivity, titers, and rapidity of four methods including papain technique, anti-globulin technique, polybrene test, and micro-column gel test for determination of IgG red blood cell antibodies. Methods Twelve kinds of IgG red blood cell antibodies such as anti-D, anti-E, anti-C, anti-c, anti-e, anti-Jk a, anti-Jk b, anti-Fy a, anti-Fy b, anti-k, anti-S, and anti-s were checked by the four methods. Results Seven kinds of IgG red blood cell antibodies including anti-D, anti-E, anti-C, anti-c, anti-e, anti-Jk a, and anti-Jk b were detected using papain technique (7/12). All of the 12 kinds of IgG antibodies were detected by anti-globulin technique (12/12). Eleven kinds of IgG red blood cell antibodies except anti-k were examined with polybrene test (11/12) and all the antibodies were also determinated by micro-column gel test (12/12). The titers of the antibodies determination suggested that papain technique was less sensitive than other three methods, while the micro-column gel test was more sensitive than other three methods in examination of all the antibodies. The lasting time of four techniques were: papain technique 45 min, anti-human globulin technique 60 min, polybrene test 5 min, and micro-column gel test 30 min. Conclusion Papain technique has some limitation in determination of IgG antibodies and anti-globulin technique is complicated because of long period incubation and multiple wash of red blood cells. Polybrene test is the most simple and convenient technique for determination of IgG antibodies. Micro-column gel test is the most sensitive method in determination of IgG antibodies.

Distribution of blood group systems in Thai blood donors determined by the gel test.

The rapid availability of fully typed donor blood is of great advantage, especially for patients requiring repeated blood transfusions. Only limited blood group antigen typing has been carried out using the conventional tube technique. This study aimed to examine the distribution of blood group systems in Thai blood donors by the gel test. The ABO, Rh, MNSs, Duffy, Lewis, P, Kell, Lutheran and Kidd blood groups were examined in 500 Thai blood donors by the gel test. The distribution of blood group systems using the gel test was compared with other studies in the Thai population. Results : For the ABO System, group O was the most common (42.6 %) followed by group B (30.8 %), group A (20.2 %) and group AB (6.4 %). The most common Rh gene complex was CCDee (53.8 %) which was similar to other studies. The MMss and MNss gene complexes were the most common in the MNSs System. Fya was very common as in other Asians. In the Lewis System, the incidence of Le (a-b-) was 21.0 %, which is consistent with other findings in the Thai population. One hundred and forty-five (29 %) were positive for anti-P1. For the Kell System, 1 out of 500 (0.2 %) had the Kk type, 99.8 % had the kk types and only Kpb positive types were observed in this study, as well as Lu (a-b+) in the Lutheran System. The Jk (a-b-) was not found since it is a rare phenotype among Thai people. Discussion : This study shows the blood group distribution in 500 Thai volunteers using the gel test. Because of its simplicity and efficacy, this test is practical in population studies. Additionally, it is useful for mass screening and can be applied in emergency situations.

Unexpected Antibody Positivity with the Use of the LISS/Coombs Gel Test / 대한임상병리학회지

BACKGROUND: There is a recent trend of increased use of the gel test for the detection of unexpected antibodies (Abs) because of its simplicity and ease with which definitive interpretation can be made. However, because of the low insurance payments in Korea, only the LISS/Coombs card is used and thus the detection rate of the cold Abs has decreased. We have studied the detection rates of the Abs in patients by using the LISS/Coombs gel test and thus evaluated the clinical usefulness of the LISS/Coombs gel test. METHODS: Abs screening tests have been carried out using the DiaMed(TM) LISS/Coombs gel card test (Murten, Switzerland) on 14,942 patients for whom blood transfusions were ordered between July 1, 1997 and March 31, 2001. When the test for Abs was positive, Ab identification tests were further carried out with the DiaMed(TM) LISS/Coombs gel card and the ID-DiaPanel 1-11. RESULTS: Eighty-one out of 14,942 patients (0.54%) revealed positive results. Of these, 15 showed anti-E, 5 showed anti-E+c, 4 showed anti-C, 3 showed anti-D, 2 showed anti-Jk(a), 1 each showed anti-c, anti-M, anti-Lu(a), and anti-K Abs. CONCLUSIONS: Although the detection rate for the cold Abs of the LISS/Coombs gel test was low, it is considered to be highly useful because of the high detection rate for the clinically important warm Abs, the simplicity in carrying out the test, and the easy readability of test results.

An Evaluation of Gel Test for Irregular Antibody Screening / 대한수혈학회지

BACKGROUND: The application of gel test to routine immunohematologic works brought on easier interpretation of results and better quality control over conventional tube method. Under the current Korean medical insurance system however, it is very difficult to apply gel test to all routine immunohematologic works because of high cost. We tried to assess its applicability to irregular antibody screening. MATERIALS AND METHODS: Antibody screenings of 2,005 sera from transfusion-scheduled patients were carried out using DiaMedTM LISS/Coombs gel card. Antibody identifications of screen-positive or screen-negative but incompatible cross matched sera were done by conventional tube method firstly, and then by DiaMedTM LISS/Coombs gel test or DiaMedTM NaCl/Enzyme gel test in the cases of negative results for conventional tube method. RESLUTS: Total 34 irregular antibodies (8 warm and 26 cold antibodies) were screened by gel test. For warm antibody screening, the reactivity of LISS/Coombs gel test was much higher than that of conventional tube method, and for cold antibodies, tube method or NaCl/Enzyme gel test revealed better reactivity. CONCLUSION: Antibody screening by LISS/Coombs gel test alone appears to be enough for detecting clinically significant warm antibodies.