Correlation between unexpected antibody types and transfusion efficacy in patients with autoimmune hemolytic anemia (AIHA) / 中国输血杂志

【Objective】 To analyze the antibody types of autoimmune hemolytic anemia(AIHA) patients in Panyu district, Guangzhou and track the therapeutic effect of blood transfusion, so as to provide reference for clinical transfusion treatment strategy of AIHA patients. 【Methods】 From January 2021 to October 2023, 96 ambiguous cross-matching blood samples from Blood Transfusion Departments of local hospitals sent to Panyu Central Blood Station were analyzed, and 25 samples of AIHA patients were identified. Then blood group identification, Rh system antigen phenotyping, antibody screening and cross-matching were further performed to analyze the correlation between antibody types and transfusion efficacy in AIHA patients. 【Results】 Among the 25 samples of AIHA patients, 17 showed consistency between forward and reverse blood grouping and 8 showed discrepancy. There were 19 (19/25, 76%) samples incompatible in cross match on the major side, of which 18 (18/19, 94.7%) were positive for direct Coombs test, autoantibodies and non-specific antibodies, and 1 (1/19, 5.3%)was positive for autoantibody and alloantibody.There were 6 (6/25, 24%) samples compatible in cross match on the major side, of which 3 (3/6, 50%) were positive for autoantibodies, 3 (3/6, 50%) were positive for autoantibody and alloantibody. Of the 25 AIHA patients, 20 received blood transfusion treatment and could be traced, and 5 patients did not receive blood transfusion treatment or transferred to other hospitals and could not be traced. Blood transfusion was effective in 11 (11/20, 55%) cases, partially effective in 6 (6/20, 30%) cases, and ineffective in 3 (3/20, 15%) cases. Among the ABO blood group incompatibility samples, transfusion was effective or partially effective in 17 (17/20, 85%) cases. 【Conclusion】 The transfusion efficacy of AIHA patients is not directly related to the results of cross-matching. Under the premise of regulating the autoimmune environment and eliminating the ABO blood group incompatibility caused by unexpected alloantibodies, AIHA patients with incompatible cross-matching can be transfused when necessary, and transfusion of ABO and Rh system antigen homologous blood can improve the safety and efficiency of transfusion.

Distribution of platelet antibodies and their specificity in Zhongshan area / 中国输血杂志

【Objective】 To investigate the frequency of platelet antibodies in voluntary blood donors and patients in Zhongshan, Guangdong Province, and to study the specificity and cross-matching of platelet antibodies. 【Methods】 Platelet antibodies of blood donors and patients were screened by solid-phase immunoadsorption (SPIA), rechecked by flow cytometry (FCM), and antibody specificity was identified by PakPlus enzyme immunoassay, and platelet cross-matching was simulated by SPIA. 【Results】 A total of 1 049 blood donor samples and 598 patient samples were tested, with 6 (0.57%) and 49 (8.19%) samples positive for SPIA,respectively(P<0.05); In SPIA positive samples, the positive concordance rate of FCM in blood donors and patients was 100% vs 95%, and that of enzyme immunoassay was 100% vs 88%. Among the initial screening positive samples of blood donors, 5 were anti-HLA Ⅰ antibodies, accounting for 83%, and 1 was anti CD36 antibody, accounting for 17%, with an incidence rate of 0.10%. Among the 14 samples of enzyme immunoassay positive patients, 2 were anti-GP Ⅱb/Ⅲa, 1 was anti-GP Ⅱa/Ⅱa, 8 were anti HLA Ⅰ, and 3 were mixed antibodies (HLA Ⅰ, GP Ⅱb/Ⅲa, GP Ⅰa/Ⅱa). According to the types of antibodies, HLA Ⅰ antibodies were the most common, accounting for 65% (11/17), followed by HPA related anti GP, accounting for 35% (6/17). The majority of patients had a platelet antibody positive typing rate below 30%, accounting for 71.4% (10/14). 【Conclusions】 The positive rate of platelet antibody of patients in Zhongshan area is significantly higher than that of voluntary blood donors, and most of them are anti-HLA Ⅰ and anti-GP, and the incidence of anti-CD36 is extremely low. Therefore, it is necessary to establish a known platelet antigen donor bank, and at the same time, carry out platelet antibody testing and matching of patients, which is helpful to solve the issue of platelet transfusion refractoriness.

Analysis of Irregular Blood Group Antibody Distribution and Blood Transfusion Efficacy in Patients with Malignant Tumor / 中国实验血液学杂志

OBJECTIVE@#To investigate the distribution of irregular blood group antibodies in patients with malignant tumors, and to analyze the relationship between it and efficacy of blood transfusion in patients.@*METHODS@#5 600 patients with malignant tumors treated in Shanxi Bethune Hospital from January 2019 to December 2021 were selected as the research subjects. All patients received blood transfusion, and cross matching test was conducted before blood transfusion, irregular antibody results of patients were tested; the irregular distribution of blood group antibodies was observed, and the relationship between it and efficacy of blood transfusion in patients was analyzed.@*RESULTS@#Among 5 600 patients with malignant tumors, 96 cases were positive for irregular antibody, and the positive rate was 1.71%; the main blood group systems involved in the irregular antibody positive of 96 patients with malignant tumors were RH, MNSs and Duffy system, among which Rh blood group was the most common, and the proportion of anti-E was the highest; among the malignant tumor patients with positive blood group irregular antibody, the proportion of female was higher than that of male; the proportion of patients aged >60 years was the highest, followed by patients aged >40 and ≤50 years, and the proportion of patients aged 18-30 years was the lowest; the patients with positive blood group irregular antibody were mainly in blood system (including lymphoma), digestive system, reproductive and urinary system; the positive rate of irregular antibody of patients in the ineffective group was higher than that of patients in the effective group, the difference was statistically significant (P<0.05). Logistic regression analysis results showed that, irregular antibody positive was a risk factor for ineffective blood transfusion in patients with malignant tumor (OR>1, P<0.05).@*CONCLUSION@#The irregular blood group antibody positive of patients with malignant tumor are mostly female, and the proportion of patients aged >60 is the highest, which is mainly distributed in malignant tumors of blood system, digestive system and urogenital system, and the positive blood group irregular antibody is related to the efficacy of blood transfusion in patients.

Blood matching incompatibility caused by cold autoantibodies and IgG anti S antibody: a case report / 中国输血杂志

【Objective】 To analyze the serological characteristics of an anemia patient with cold autoantibodies and IgG anti S antibody. 【Methods】 Unexpected antibody screening was performed on screening cells, autologous cells and panel cells with patient serum in saline and anti human globulin card media at room temperature and 37 ℃, respectively. At the same time, the serum that destroying IgM antibodies and acid elution solution were respectively screened for unexpected antibodies in anti human globulin card media. The absorption-elution test was used to treat patients′ red blood cells and serum, and the unexpected antibody identification and cross matching were performed after excluding the interference of cold autoantibodies. 【Results】 Cold autoantibodies and IgG anti S antibody were found in the serum of this patient. 【Conclusion】 When a patient is found to have cold autoantibodies, it is necessary to screen the alloantibody, in order to avoid post transfusion immune reactions due to missed detection of alloantibody.

Identification and clinical transfusion of B (A) subgroup / 中国输血杂志

【Objective】 To carry out serological and molecular biological identification of B (A) subtype, and discuss the rational blood transfusion strategy. 【Methods】 Serological and direct sequencing methods were used to detect serotype and genotype of 7 cases of B (A) subtype, and cross matching was performed by saline medium and anti human globulin card to analyze the red blood cells(RBCs) transfusion strategy. 【Results】 The serology results of blood type of 7 samples were similar, with B(A)04/O01 in 3 cases, B(A)04/O02 in 2 cases and B(A)02/O01 in 2 cases. 7 cases of B (A) subtypes were matched with randomly selected blood donors of type O and B on the major side. 【Conclusion】 B(A) subtypes should be identified by genotyping techniques. Washed RBCs of type B and O can be used for B(A) blood type transfusion.

Research on a new microtubule technology of reagent bursting for crossmatching test / 中国输血杂志

【Objective】 To develop a quick and accurate crossmatching test technology without the power equipment and additional reagents before blood transfusion, so as to improve the timeliness and safety of blood transfusion treatment in sudden situations as war or natural disasters. 【Methods】 The irregular antibodies quickly promote coagulants (QPC) were used as the reaction medium reagent. The 200 μL QPC were wrapped in the bursts bead and preset within different recess of the detection tubes. The bursts beads were squeezed with the reagent left in the well, then the blood samples were dropped in the main(recipient plasma: 200 μL, donor 3%—5% RBC: 100 μL) and secondary(donor plasma: 200 μL, recipient 3%—5% RBC: 100 μL)reaction grooves. The result interpretated by hand wrestling or 1 500 g centrifugation of 15 seconds. Meanwhile, the comparing experiments with the prior methods were implemented to evaluate the method’s reliability. 【Results】 The results of the bursting reagent, being stored at 37℃ for one week, were consistent with those of the freshly prepared cross-matching reagent, indicating that the bursting reagent was practical in the field and had good stability at normal temperature. No statistical difference between the sensitivity and the results of the microcolumn gel method was noticed by paired data t test (P>0.05). The parallel cross matching tests of 50 clinical samples were performed by microcolumn gel method and coagulant-bursting technique; the Kappa value was 0.973 2, and irregular antibodies were detected in 2 cases, with concordance rate at 100%, showing good consistency. 【Conclusion】 The improved method is simple and fast, and also safe and reliable for compatibility testing before blood transfusion, which is especially suitable for the field rescue of the wounded in wartime and sudden natural disasters, and is worthy of popularization.

Effect of red blood cell preservation solution on serum agglutination reaction of specific patients / 中国输血杂志

【Objective】 To explore the precautions of pre-transfusion examination in patients with antibodies to erythrocyte protective solution, discrepant ABO blood typing results, and positive unexpected antibodies, so as to ensure the safety of blood transfusion. 【Methods】 The screen cells were divided into two groups according to the presence or absence of washing reagent red blood cells in normal saline. One group had untreated forward typing cells, antibody screening cells and identification panel, and the other group had saline-washed reverse typing cells, antibody screening cells and identification panel. The experiments were carried out by microcolumn gel method, saline medium method and polyamine method to analyze the effect of red blood cell preservation solution on serum agglutination reaction of specific patients. 【Results】 Among the 8 patients, forward typing was AB (+ ) in 1 patient, B (+ ) in 4, and A(+ ) in 3, and the reverse typing were interfered. The plasma of 8 patients agglutinated with unwashed reverse typing cells (saline tube method), screen cells and identification panels (saline tube method plus cassette method), while not agglutinated with the polybrene method. The interference was eliminated as using washed reverse typing cells (salinetube method), screen cells and identification panels (saline tube method plus cassette method). 【Conclusion】 The erythrocyte preservation solution affected patients’ blood group typing, but not affected the outcome of blood transfusion as no adverse reactions occurred.

Construction and application of platelet virtual matching information system / 中国输血杂志

【Objective】 To construct a platelet digital matching information system (PMIS). 【Methods】 The framework of PMIS was designed and the main functions were developed. The information system was connected with the information modules of clinical application, laboratory testing, blood donation service, blood inventory and distribution. Further, the preliminary application of this system will be carried on in clinical. 【Results】 The PMIS had been successfully developed and 5048 blood donors with HLA and HPA genotypes were registered in the system. A total of 306 patients applied for matching and 16.5% of them received compatible platelet reports immediately from the inventory bloods, with the median waiting time of all matching as 3 days, which was significantly shorter than that of the manual method (3.8±3.1 days vs 5.4±5.4 days). 【Conclusion】 The developed PMIS has realized the whole process management of blood donors and patients, which is helpful to improve the platelet matching level.

The challenging blood cross-matching and resolution for multiple myeloma patients in different disease stages / 中国输血杂志

【Objective】 To explore the challenging blood cross-matching and resolution for multiple myeloma (MM) patients in different disease stages. 【Methods】 For a patient who was first diagnosed as MM and scheduled for blood transfusion, his blood was cross matched with donors’ blood by microcolumn gel method and tube test. When the major side of cross-matching was agglutinated, the patient’s plasma was cross matched with donors’ red blood cell (RBC) by polybrene test, then plasma dilution cross matched with donors’ RBC by microcolumn gel method. For a patient who was diagnosed as recurrent refractory MM and scheduled for blood transfusion, his blood was cross matched with donors’ blood by microcolumn gel method. 【Results】 1) Case 1 was a first-visit outpatient. The major side of microcolumn cross-match test was agglutinated with the shape of fine line. The result of tube method also showed agglutination of major sides, and the rouleaux were detected by the microscopy. Then polybrene method and microcolumn gel method (after plasma diluted) were applied for cross-matching again with the above two donors’ blood and showed compatibility. 2) Case 2 was a recurrent refractory MM patient. The major and minor sides of microcolumn cross-match test were both agglutinated with the shape of granular. The patient was treated with anti-CD38 monoclonal antibody. The RBCs, after treated with dithiothreitol (DTT) was used to cross match with patient plasma by microcolumn test, and the result was compatible. 【Conclusion】 Polybrene method and microcolumn gel method after plasma diluted are suitable for blood cross-matching of newly diagnosed MM patients, also for those treated with CD38 monoclonal antibody, as the drug interference with cross-matching can be eliminated by DTT.

Study on the safety of homotype transfusion of military blood donors with negative unexpected antibodies / 中国输血杂志

【Objective】 To analyze the safety of homotypic transfusion in military donors with negative unexpected antibody. 【Methods】 Blood samples (4 mL/person)of eligible military blood donors from November 2018 to October 2019 in our hospital (also working as forces blood station) were conducted for RBC antigen typing, unexpected antibody screening, direct antiglobulin test and cross-match test using microcolumn gel technology, and the compatibility of homotype blood samples was statistical analyzed. 【Results】 A total of 1 577 samples from eligible military blood donors were collected, including A RhD (+ ), B RhD (+ ), O RhD (+ ) and AB RhD (+ ), accounting for 31.39% (495/1 577), 34.37% (542/1 577), 24.10% (380/1 577) and 10.15% (160/1 577), respectively. Six samples presenting positive unexpected antibodies (0.38%, 6/1 577) were screened out, and a total of 7 141 cross-matching tests were performed on 1 571 unexpected antibody negative samples, including A RhD (+ ) [37.36% (2 668/7 141)], B RhD (+ ) [34.81% (2 486/7 141)], O RhD (+ ) [17.71% (1265/7 141)] and AB RhD (+ ) [10.11% (722/7 141)]. There was only 1 case of incompatible cross-matching presented between other donors and clinical patients, and the direct antiglobulin test was 1+ , therefore suspended red blood cells of the donor were scrapped. 【Conclusion】 There was high compatibility and good security of homotype transfusion of military blood donors with negative unexpected antibody.

Blood type incompatibility caused by cold agglutination: A study of 16 cases / 中国输血杂志

【Objective】 To investigate the effect of cold agglutination on blood group typing. 【Methods】 37℃ water bath, absorption elution test and 2-mercaptoethanol method were used to eliminate the influence of cold agglutination. Forward and reverse blood group typing, cross matching, DAT and IAT experiments were then performed on red blood cells and serum after treatment. 【Results】 Before treatment, obvious discrepancy in forward /reverse typing and nontypable cross matching in 16 blood samples were noticed due to cold agglutination. After corresponding treatments, all samples were consistent or negative in forward/reverse typing, cross matching and antibody screening. No adverse reactions to cross matching blood transfusion occurred in patients, and the increase of hemoglobin was in line with the effective standard of transfusion. 【Conclusion】 37℃ water bath, absorption elution test and 2-mercaptoethanol method can be used to eliminate the interference caused by cold agglutination to obtain correct typing results. The strong reactivity caused by cold agglutination in AIHA patients were different from other cases, which deserved our attention.

Impact of monoclonal anti-CD47 on pre-transfusion testing and its solution / 中国输血杂志

【Objective】 To explore the impact of monoclonal anti-CD47(IBI188) on clinical pre-transfusion testing and its solutions, then compare it with monoclonal anti-CD38, so as to develop safe and rational transfusion strategies. 【Methods】 The blood typing, direct antiglobulin testing(DAT) and antibody screening were conducted by standard methods. Red blood cells(RBCs) were treated with fig protease, papain, trypsin and dithiothreitol(DTT) to observe whether the effect of monoclonal anti-CD47 could be eliminated. Cord RBCs and RBCs with different Rh phenotypes were cross-matched; Plasma samples were adsorbed with papain-treated O allogeneic RBCs. 【Results】 ABO reverse typing were affected by monoclonal anti-CD47 treatment, and all serum antibody screening were positive, and their DAT were negative or weakly positive. Neither enzyme nor DTT could weaken the effect of monoclonal anti-CD47 on antibody screening. In saline cross-matching, differences in agglutination intensity were corresponded to differences in CD47 expression on RBCs, but all RBCs agglutinated 2+ to 4+ by polybrene method and anti-human globulin method. Papain treated allogeneic RBCs can remove the monoclonal anti-CD47 in the serum through 3 to 4 rounds of absorption. 【Conclusion】 Monoclonal anti-CD47 interferes with pre-transfusion testing, which can be removed by allogeneic RBCs absorption(not suitable for antibody screening or cross-matching), but not by enzyme or DTT. Blood typing and antibody screening should be conducted before monoclonal anti-CD47 treatment and patients should be transfused with homozygous matched RBCs.

Solutions to cross-matching incompatibility in clinical: retrospective study of 1 770 cases in Shenzhen / 中国输血杂志

【Objective】 To analyze the blood samples sent by hospitals in Shenzhen to solve ABO cross-match incompatibility during 2011 to 2020, so as to find corresponding solutions to improve the efficacy of blood transfusion. 【Methods】 The clinical data of 1 770 cases of cross-match incompatibility in our laboratory from January 2011 to December 2020 were collected and reviewed. The causes of cross-match incompatibility were analyzed, the types of unexpected antibodies were determined. The overall incidence of antibodies was evaluated by statistical method of classified variables. The safety of blood transfusion was safeguarded by ABO homotype plus cross-matching compatibility. 【Results】 1) The 1 770 samples, presenting cross-matching incompatibility, involved 956 patients. The average number of cross-matching per patient from 2011 to 2015 was 1.32(307/232), which increased from 1.27(103/81) in 2016 to 2.23(286/128) in 2018, and remained stable in 2019 and 2020. 2) Among 956 patients, auto-and/or allo-antibody in plasma were yielded in 90.38%(864/956), including auto-antibody plus alloantibody in 42.26%(404/956), solo auto-antibody in 20.71%(198/956) and solo allo-antibody in 27.41%(262/956). Up to 20 kinds of specific allo-antibodies were detected, belonging to 8 blood groups. Among them, 70.82%(551/778) were Rh blood group, such as anti-E(37.15%)>anti-c(20.95%)>anti-C(5.27%)=anti-e(5.27%)>anti-D(2.19%), followed by MNS [11.40%(112/778)], Kidd [5.66%(44/778)], Leiws [3.21%(25/778)], Duffy [1.80%(14/778)], Diego [1.03%(8/778)], P1 [0.39%(3/778)] and H [0.26%(2/778)]. 3) 86%(37/43) of multiple transfusion recipients, aged below 20 years old, were thalassemia, and 1-4 kinds of allo- and/or auto-antibody were yielded. 【Conclusion】 The cross-matching incompatibility were mainly caused by allo- and/or auto-antibodies, which may be induced by blood transfusion, pregnancy or autoimmune diseases such as autoimmune hemolytic anemia.Those suspicious blood samples in clinical should be sent to blood group reference laboratory for further determination, in order to ensure the safety and efficacy of blood transfusion.

Treatment of platelet transfusion refractory caused by anti-HLA in pregnancy complicated with aplastic anemia / 中国输血杂志

【Objective】 To find the HLA-matched platelets from platelet donor registry and track the transfusion effect for aplastic anemia patients in pregnancy with platelet transfusion refractory (PTR) caused by anti-HLA, so as to support the childbirth and follow-up treatment of the patients. 【Methods】 Antibodies to HPA and HLA were detected by ELISA kit and Luminex, respectively. DNA of the patient and 523 platelet donors from the donor registry were extracted for high-resolution HLA genotyping. The Risk Factors Evaluation Software of PTR was used to select the ABO-compatible and HLA-matched donors, without HLA Eplets specific to the patient. After MASPAT cross matching, the patient was transfused with 1 U of platelets, and the 24h post-transfusion effect was recorded. 【Results】 Only anti-HLAⅠantibody was found in the patient serum, and the specificity Eplet was 65QIA, including HLA-B*27∶08, B*27∶05, B*07∶02, B*55∶01, B*67∶01 and B*54∶01; anti-HLA Ⅱ antibody was negative. The HLA genotypes of both the patient and donor were HLA-A*02∶07, A*11∶01, B*46∶01, B*46∶01, C*01∶02, 01∶03, DRB1*04∶05, DRB1*0901, DQB1*03∶03 and DQB1*04∶01. The results of MASPAT matching were negative. HLA-matched platelets transfusion provided a satisfactory posttransfusion platelet responses in patients(1 before vs 33 ×109/L after). A baby boy was delivered by cesarean section 4 weeks later, and the same donor was recruited due to the mother′s low Plt and bleeding trend. The 24h posttransfusion Plt (×109 / L) rose from 5 to 37 after the secondary transfusion of 1U platelet. The vital signs of the mother and her baby were normal during the two-day follow up. 【Conclusion】 The establishment of blood donor registry and screening of HLA-matched donors is an effective approach to treat PTR caused by HLA antibodies in pregnancy complicated with aplastic anemia.

To remove monoclonal anti-CD38 interference from compatibility testing: A simple method / 中国输血杂志

【Objective】 To explore a simple method to remove the interference of monoclonal anti-CD38 from compatibility testing and evaluate its effectiveness and safety, in order to develop a reasonable clinical transfusion strategy. 【Methods】 Blood phenotype detection, direct antiglobulin testing(DAT) and antibody screening were carried out by standard methods. Antibody screening and cross-matching of serums after monoclonal anti-CD38 treatment were performed by anti-human globulin card with 0.2 mol/L or 0.04 mol/L dithiothreitol(DTT) treated red blood cells. 【Results】 The results showed that 0.04 mol/L DTT treated directly in the anti-human globulin card for 15 min can completely remove the interference of monoclonal anti-CD38 in antibody screening and cross-matching without compromising of the yielding of anti-K, anti-LW, anti-JMH and anti-Lub alloantibodies. However, the titer of IgM antibodies may decrease in different degrees, and antibody screening and cross-matching with saline methods are required to avoid the missed detection of IgM alloantibodies. All 12 patients had no acute or delayed haemolytic transfusion reactions and their routine blood tests showed that the red blood cells transfusion were effective. 【Conclusion】 Based on antibody screening and cross-matching plus saline method, the method of 0.04 mol/L DTT, treated directly in the anti-human globulin card, is safe, effective and simple, which can detect most alloantibodies.

Approaches against the interference of autoantibodies with pre-transfusion compatibility testing / 中国输血杂志

Pre-transfusion compatibility testing is complicated in autoimmune hemolytic anemia (AIHA) patients due to the presence of autoantibodies. Delays in blood transfusion or even life-threatening would occur if blood type, isoantibodies/ autoantibodies of these patients could not be correctly identified to choose the appropriate blood components. Knowing the detection and treatment countermeasures against blood transfusion compatibility in AIHA patients is of great significance to ensure the timeliness and safety of blood transfusion. Based on the research progress at home and abroad, this article summarizes the serological characteristics, autoantibody types, blood group identification methods, antibody screening and antibody identification methods, and blood transfusion strategies about AIHA patients, in order to eliminate the interference of autoantibodies and provide transfusion guidance for the staff of Blood Transfusion Department.

Effect of sample processing at 56℃ for 30 min on routine examination in Department of Blood Transfusion / 中国输血杂志

【Objective】 To investigate the effect of sample processing at 56℃ for 30 min on routine examination in Department of Blood Transfusion. 【Methods】 A total of 40 cross matched blood samples submitted by clinical departments of our hospital, were collected, and each sample was equally divided into two. Before and after heating at 56℃ for 30 min, the ABO blood group was detected by manual method and card method (gel card and glass beadle card), antibody titer was detected by coagulant method, and cross-matching was conducted by anti-globulin card method. Chi-square test and Wilcoxon signed rank test were used to compare the differences between the two groups (before and after heating treatment). 【Results】 The blood group detection rates of the experimental group were 100% (40/40), 37.5% (15/40) and 80% (32/40) by manual test tube method, gel card and glass beads card, respectively, P0.05). The matching rate of two groups of samples, cross-matched with corresponding donor samples, was both 100% (40/40) by coagulant method, and 100% (40/40) vs 25% (10/40) respectively by the antiglobulin card method (P<0.01). The other 30 samples in the experimental group presented weak agglutination in the secondary side. 【Conclusion】 The treatment of virus inactivation at 56℃ for 30 min has little effect on blood group identification by test tube method, antibody titer and cross-matching by coagulant method, and reduceds the occupational exposure of staff in Blood Transfusion Department.

Evaluation of the Automated Cross-Matching Instrument, ORTHO VISION, for Use in Blood Banks

BACKGROUND: Automated systems are used widely for pre-transfusion tests in blood banks, in an attempt to reduce effort and human error. We evaluated the clinical performance of an automated blood bank system, ORTHO VISION (Ortho-Clinical Diagnostics, Switzerland), for blood cross-matching. METHODS: Saline cross-matching was performed for 93 tests using 56 samples. Coombs cross-matching was performed for 400 tests using 166 samples. Saline cross-matching was compared for the automated ORTHO VISION and manual tube methods. Coombs cross-matching was compared for the automated ORTHO VISION and manual column agglutination technique (CAT) methods. The evaluation of 32 antibody-positive samples using the automated ORTHO VISION and manual CAT methods was compared by performing 97 cross-matching tests. Additionally, the ORTHO VISION efficiency and carryover were evaluated. RESULTS: The concordance rate of the saline cross-matching results between the manual method and automated ORTHO VISION was 100%. The concordance rate of coombs cross-matching results between manual CAT and automated ORTHO VISION was 97.9%. The concordance rate of cross-matching for antibody positive samples between manual CAT and the automated ORTHO VISION was 97.9%. Coombs cross-matching was efficient using ORTHO VISION, whereas saline cross-matching was efficient using the tube manual method. CONCLUSIONS: ORTHO VISION showed reliable results for cross-matching and was more efficient than manual CAT for coombs cross-matching. Thus, ORTHO VISION can be used for pre-transfusion tests in blood banks.

Evaluation of the use of blood in surgeries as a tool to change patterns for requesting blood product reserves

OBJECTIVES: Thirty to sixty percent of prepared blood products are not transfused. Blood reserves for surgeries lead to many unused blood products, which increases hospital costs. The aim of this study is to identify the request and use profiles of blood products for elective surgeries in different surgical specialties, the influence of surgery time and demographic, clinical, and laboratory variables on the number of red blood cells (RBCs) used and to calculate the rate of transfused patients (RTP) and cross-matched and transfused (C/T) RBCs. METHODS: Observational and prospective studies. Sociodemographic, clinical and quantitative data on the request and use of blood products were collected. The influence of the data on the use of RBCs was examined by binary logistic regression. Chi-square, one-way ANOVA and Kruskal-Wallis tests were utilized to compare the data among the specialties. RESULTS: In total, 822 procedures were included. Most of the requested blood products were not used, even 24 hours postoperatively. Of the 2,483 RBC units, 314 were transfused, leaving 87.6% unused; however, cardiac, digestive tract, vascular, gynecologic, urologic and thoracic surgery procedures transfused 50%, 25%, 16.5%, 11%, 9.5% and 8.1% of requested RBCs, respectively. The factors that influenced the transfusions were age, time of surgery and cardiac surgeries. The RTP was >10% in 22 surgical types and <1% in 24 surgical types, and 88% of samples presented a C/T ratio >2.5. CONCLUSION: The RTP and C/T ratios can guide RBC requests in the preoperative period. Knowing the standard of use of blood products and developing protocols enables the optimization of reserves, reduction of costs and improvement of care.

Comparison of two different workflows of crossmaching by full-automatic blood grouping instrument / 国际检验医学杂志

Objective To provide an optimal working process for crossmatching by full-automatic blood typing instrument.Methods Two workflows were applied to crossmatch test by full-automatic blood typing instrument.One was diluting red blood cells of donor samples to concentrate of 1%,the other was detecting directly the donor′s packed red blood cells.Compared consistency and processing time of the two different workflows.Results Cross match results of two workflows were consistent well(U=0,P>0.05).The average processing times before testing and undergoing testing were not significantly different(t=0.692,t=0.562,P>0.05),whereas the average processing times after testing and throughout testing were significantly different(t=146.485,t=67.053,P<0.05).Conclusion The workflow of diluting donor′s sample before testing saved processing time and better suits hospital having a large quantity of specimens.