RESUMEN
Immunohematological procedures are based on the interaction between red cell antigens and specific antibodies. Evidence for the in vitro formation of an antigen-antibody reaction is traditionally based on the visualization of agglutinates or the presence of hemolysis. The conventional tube test with an indirect antiglobulin test is considered as the gold standard for detecting hemagglutination. Currently, commercial gel tests are used to detect hemagglutination. We aimed to evaluate our in-house developed gel (K-Med gel) against the conventional tube and commercial gel tests. To evaluate the specific gels, samples from 500 patients were tested for ABO and Rh(D) blood group and samples from 500 donated blood were tested for C, c, D, E and e antigens. The sensitivity of the neutral and antiglobulin gels were tested and compared to the commercial gels and the tube tests. The K-Med gel was used for antibody screening on 531 samples. The K-Med specific gel was able to identify ABO and Rh (CcDEe) blood groups as same results as the tube test did. Similarly, the sensitivity of the neutral and antiglobulin K-Med gel was as good as the commercial gels but higher than the tube method. In antibody screening test, 33 of 531 samples were positive. The gel test was able to detect clinically significant antibodies more frequently than the tube method (3 samples). While the tube method was able to detect non clinical significance antibodies more frequently than the gel test (4 samples). In conclusion, K-Med gel is recommended to be used for ABO and Rh blood grouping instead of using the tube method. The neutral and antiglobulin gel were able to detect the antibody-antigen reaction on red blood cells, especially the clinically significant antibodies. The K-Med gel can be applied for micro-plate system, which makes it easier to perform and less time consuming. It is also therefore suitable for routine testing in high work load laboratories.
RESUMEN
It is the responsibility of all blood transfusion laboratories to ensure that donated blood is used efficiently and effectively and to minimize waste while maintaining sufficient stock to deal with unexpected life-threatening emergencies. This study was conducted to determine the adequate stock level needed to operate the Blood Transfusion Center of the Faculty of Medicine, Khon Kaen University. We accessed the total number of transfusion units and cross-matching of blood components from our data base for 2009. The average daily weekly and monthly use was calculated. A stock of blood components (viz., red cells and plasma) is kept for 7 and 3 days, respectively. Stocks of platelets are kept for 3 days and cryoprecipitate for 4 weeks. The stock levels included blood for emergencies (10 %) and to cover the expected growth in use over the year before (based on historical growth rates/usage). The results of our study showed an increased utilization in 2009 of: red cells 3.1 % (28,202 units); plasma 14.1 % (18,268 units), platelet concentrates 20.3 % (22,754 units) and cryoprecipitates 28.0 % (11,178 units). The ideal blood inventory of red cell products in 2010 should be 766 units; 158, 266, 288 and 54 units of blood group A, B, O and AB, respectively. The respective blood inventory for plasma, platelets and cryoprecipitates should be 548, 238, 1297 units. We also found that the red cell products would cover 3 days in the event of a shortage in the blood supply. The ideal blood inventory for our Blood Transfusion Center will be based upon this evidence. However, the inventory needs to be frequently checked for quality assurance and up-to-date stock counts. When the inventory level gets low, planning for restocking the blood supply should be done immediately as per policy. A statistical report on inventory levels throughout the year should be done each year for planning and evaluation purposes.
RESUMEN
Human Leukocyte Antigen (HLA) is an antigen system found on surface of white blood cells and body tissues. Their functions are related to immune response to recognize and eliminate foreign antigens. Many diseases are associated with HLA alleles, especially HLA-B*27 which is strongly associated with ankylosing spondylitis (AS). In this study, the high resolution PCR-SSP has been developed to detect HLA-B*27 by 2 primer mixtures (Sc1 and Sc2). The HLA-B*27 group specific primers have been tested in 846 unrelated healthy northeastern Thais (NET), 338 northern Thais (NT), 271 Karens and 308 Burmese. Sixty-three NET (7.4 %), 24 NT (7.1 %), 5 Karens (1.8 %), and 12 Burmese (3.9 %) were positive for HLA-B*27. This study established a simple technology for HLA-B*27 testing and provided basic information for assessing the risk of AS and further study in disease associations.