Investigation of Discrepant ABO Blood Grouping Results from an Autoanalyzer
2
조회
0
다운로드
3
인용
0
참고문헌
키워드
초록
Background: A paucity of studies evaluating failed cases of ABO grouping using autoanalyzers exists. We investigated autoanalyzer rejected cases, including serologically suspicious ABO subgroups and discrepant ABO blood grouping results from Erytra Eflexis (Grifols, Spain), to demonstrate efficient use of autoanalyzers for ABO grouping. Methods: Samples requested for ABO grouping throughout 2020 were tested using two Eflexis instruments and standard ABO RhD and reverse grouping cards. Neonatal cards were not used. When necessary, a conventional tube technique (TUBE) was used to resolve rejected/discrepant Eflexis ABO grouping results. Results: The overall sample rejection rate (RR) was 3.2% (628/19,466), 1.3% of which were due to various error flags and 1.9% for discrepant results. Cases from neonates ≤1 year old accounted for 35.3% of the rejected cases based on Eflexis results. The ABO groups with the highest and lowest RR (excluding neonates) were A and O, respectively. The 628 samples resulted in 682 rejections, which were frequently associated with reverse grouping, including 28.4% against A1 and 54.5% for B red cells. Among 14 serologically weakened A and/or B blood groups, six A2BW and two ABw, which had been missed by Eflexis, were detected using TUBE and our follow-up laboratory criteria. Conclusions: The ABO group and a proportion of neonatal samples influenced the RR due to weak reverse grouping reactivity, especially toward B red cells. Confirmatory ABO grouping by TUBE in a new patient and/or extra rejection criteria for forward grouping are needed to detect cis-AB, which is relatively common in Korea.
Abstract
Background: A paucity of studies evaluating failed cases of ABO grouping using autoanalyzers exists. We investigated autoanalyzer rejected cases, including serologically suspicious ABO subgroups and discrepant ABO blood grouping results from Erytra Eflexis (Grifols, Spain), to demonstrate efficient use of autoanalyzers for ABO grouping. Methods: Samples requested for ABO grouping throughout 2020 were tested using two Eflexis instruments and standard ABO RhD and reverse grouping cards. Neonatal cards were not used. When necessary, a conventional tube technique (TUBE) was used to resolve rejected/discrepant Eflexis ABO grouping results. Results: The overall sample rejection rate (RR) was 3.2% (628/19,466), 1.3% of which were due to various error flags and 1.9% for discrepant results. Cases from neonates ≤1 year old accounted for 35.3% of the rejected cases based on Eflexis results. The ABO groups with the highest and lowest RR (excluding neonates) were A and O, respectively. The 628 samples resulted in 682 rejections, which were frequently associated with reverse grouping, including 28.4% against A1 and 54.5% for B red cells. Among 14 serologically weakened A and/or B blood groups, six A2BW and two ABw, which had been missed by Eflexis, were detected using TUBE and our follow-up laboratory criteria. Conclusions: The ABO group and a proportion of neonatal samples influenced the RR due to weak reverse grouping reactivity, especially toward B red cells. Confirmatory ABO grouping by TUBE in a new patient and/or extra rejection criteria for forward grouping are needed to detect cis-AB, which is relatively common in Korea.
참고문헌 (21)
- Elliott C, "Multicentre evaluation of Erytra Eflexis®, a benchtop fully automated analyser with a compact design for routine use in blood transfusion laboratory", Transfus Med, 29, pp.401~407 (2019)
- Roback JD, "Performance and reliability of a benchtop automated instrument for transfusion testing : a comparative multicenter clinical study in the US population", Transfusion, 59, pp.3511~3518 (2019)
- Chang C, "Evaluation of Erytra® fully automated analyser for routine use in transfusion laboratory", Transfus Med, 24, pp.33~38 (2014)
- Taylor J, "Multi-centre evaluation of pre-transfusional routine tests using 8-column format gel cards(DG Gel®)", Transfus Med, 21, pp.90~98 (2011)
- 신정원, "자동화 장비 IH-500과 수기법 간 ABO 혈액형 검사 비교", 대한수혈학회지, 28(2), pp.126~133 (2017), 대한수혈학회[DOI]
- 신소연, "수혈 전 검사 장비인 AutoVue Innova와 Techno TwinStation의 평가", Annals of Laboratory Medicine, 28(3), pp.214~220 (2008), 대한진단검사의학회
- Cheng YW, "An experience of the introduction of a blood bank automation system(Ortho AutoVue Innova)in a regional acute hospital", Transfus Apher Sci, 53, pp.58~63 (2015)
- Morelati F, "Evaluation of a new automated instrument for pretransfusion testing", Transfusion, 38, pp.959~965 (1998)
- 조수연, "Comparative Analysis of Clinical Samples Showing Weak Serum Reaction on AutoVue System Causing ABO Blood Typing Discrepancies", Annals of Laboratory Medicine, 37(2), pp.117~123 (2017), 대한진단검사의학회
- Yamaguchi H, "An A2B3 phenotype blood showing atypical mode of inheritance", Proc Jpn Acad, 41, pp.316~320 (1965)
- Cho D, "The serological and genetic basis of the cis-AB blood group in Korea", Vox Sang, 87, pp.41~43 (2004)
- Han KS, "Molecular genetic analysis of cis-AB blood group in Koreans", Korean J Blood Transfus, 8, pp.85~91 (1997)
- Chun S, "ABO mistyping of cis-AB blood group by the automated microplate technique", Transfus Med Hemother, 45, pp.5~10 (2018)
- Fung MK, "Technical Manual" (2017), American Association of Blood Banks
- Abo H, "Mollison’s Blood Transfusion in Clinical Medicine", pp.130~ (2014), Wiley Blackwell
- Economidou J, "Quantitative measurements concerning A and B antigen sites", Vox Sang, 12, pp.321~328 (1967)
- Rawson AJ, "Studies of blood groups antibodies. III. Observations on the physicochemical properties of isohemagglutinins and isohemolysins", J Immunol, 85, pp.636~639 (1960)
- 강선주, "Comparison of ABO Antibody Titers on the Basis of the Antibody Detection Method Used", Annals of Laboratory Medicine, 34(4), pp.300~306 (2014), 대한진단검사의학회
- Abo H, "Mollison’s Blood Transfusion in Clinical Medicine", pp.119~ (2014), Wiley Blackwell
- 천세종, "Cis-AB, the Blood Group of Many Faces, Is a Conundrum to the Novice Eye", Annals of Laboratory Medicine, 39(2), pp.115~120 (2019), 대한진단검사의학회[DOI]
- Korea Centers for Disease Control & Prevention, "Korean National Transfusion Guideline", Korea Centers for Disease Control & Prevention, 15~16 (2016)