Comparative Analysis of Clinical Samples Showing Weak Serum Reaction on AutoVue System Causing ABO Blood Typing Discrepancies

Jo, Su Yeon; Lee, Ju Mi; Kim, Hye Lim; Sin, Kyeong Hwa; Lee, Hyeon Ji; Chang, Chulhun L.; Kim, Hyung Hoi

doi:10.3343/alm.2017.37.2.117

Cited by 7 publications

(7 citation statements)

References 16 publications

(23 reference statements)

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“…Hemagglutination reactions for reverse grouping by TUBE were significantly stronger than those for the autoanalyzers ( Table 3 ); this phenomenon has also been reported for the AutoVue system [ 9 ].…”

Section: Discussionsupporting

confidence: 71%

“…In our study, the Eflexis analyzers could not determine the ABO group in 628 out of 19,466 cases. The Eflexis RR was 3.2% (including 1.1% for neonates up to 1 year of age), which was higher than that of 2.3% in 13,113 samples (including 1.2% for error messages) reported for the AutoVue system (Ortho-Clinical Diagnostics, Raritan, NJ, USA) [ 9 ]. However, in that study, samples from neonates up to 1 year of age were excluded, which may have affected the RR.…”

Section: Discussionmentioning

confidence: 99%

“…Group A showed the highest RR, which can be explained by the highly frequent rejected results of reverse grouping because of the absence of expected reactions against B RBCs ( Table 2 ). Likewise, weak plasma reactions on the AutoVue system causing ABO blood grouping discrepancies have been reported [ 9 ]. The number of A antigen sites (0.81–1.17×10 6 ) per RBC is higher than that of B antigen sites (0.61–0.83×10 6 ) [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

“…There are several reports on the performance and reliability of Erytra or Erytra Eflexis in pre-transfusion testing [ 1 - 4 ]. However, there is a paucity of comprehensive studies evaluating failed cases of ABO grouping using Eflexis or autoanalyzers from other companies [ 5 - 9 ].…”

Section: Introductionmentioning

confidence: 99%

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Investigation of Discrepant ABO Blood Grouping Results from an Autoanalyzer

2022

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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 A 1 and 54.5% for B red cells. Among 14 serologically weakened A and/or B blood groups, six A 2 BW 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.

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Section: Discussionsupporting

confidence: 71%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Investigation of Discrepant ABO Blood Grouping Results from an Autoanalyzer

2022

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“…Jo et al . performed a comparative study of clinical samples showing weak reactions in reverse grouping on fully automated immunohaematology analyser (AutoVue, OCD, Raritan, NJ, USA) with the manual tube technique. Among the 297 (2·3%) discrepant samples, 98 samples gave a weak reaction with the AutoVue system; 79 (80·6%) samples giving a better agglutination strength with manual tube technique.…”

Section: Discussionmentioning

confidence: 99%

ABO blood grouping discrepancies in the donor population

Jain

Garg

Marwaha

et al. 2020

ISBT Science Series

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Background and Objectives ABO discrepancies occur when the reactions in forward grouping are not corroborative to those in the reverse grouping due to weak subgroups of A and/or B, missing or weak ABO antibodies or unexpected alloantibodies. We aimed to determine the prevalence of ABO discrepancies in our donor population and to know the causes by using a standard classification. Materials and Methods It was a retrospective study on donor samples. For all the discrepant samples, the ABO and RhD grouping was repeated using tube technique. Adsorption–elution testing was done for detecting weak subgroups of A and B. Antibody screen (3‐cell) and identification (11‐cell) were done by gel technique (Bio‐Rad, Switzerland). Results We detected 93 (0·064%) ABO discrepancies out of the total 144279 donor samples tested. The ABO discrepancies were due to weak anti‐B antibody (33/93; 35·5%), weak anti‐A antibody and weak subgroups of A (24 each; 25·8% each) and weak subgroups of B (5/93; 5·4%). Agglutination with O cells was observed in 7 (7·5%) samples at room temperature testing. The alloantibodies identified in these samples were anti‐M (5) and anti‐Lea in (1), while the remaining 1 sample was of ‘Bombay’ (Oh) phenotype. The autologous control was negative for all the samples. Conclusion The prevalence of ABO discrepancies in our donor population is 0·064%.

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Establishment and application of suspension static method in blood group screening of automated blood group analyzer

Huang

et al. 2023

Sci Rep

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The accuracy of blood group identification is the basis of blood transfusion safety. In order to increase the detection rate of weak agglutination, unexpected antibodies (UAb) and blood subtypes for pre-transfusion testing, the blood group screening process of automated blood group analyzer (ABGA) is ameliorated by introducing one static step and establishing a suspension static method (SSM). One static step was introduced in the blood group screening process of ABGA and three static time conditions were designed: 300 s, 400 s and 500 s, from which the optimal static time was selected and SSM was established; By comparing the detection of weak agglutination and UAb before and after the application of SSM, the feasibility and effect of suspension static method were verified and evaluated. The last two steps of the automatic blood group screening process were replaced with static, light centrifugation and imaging. The optimal static time parameter was selected as 400 s and SSM was established; After the application of SSM, it was verified that: (1) The detection level of weak antibodies (anti-A and anti-B) and weak antigens (weak D phenotype) could be improved by SSM, including antibodies in plasma of known type O samples with 0, 2, 4, 8, 16 and 32 times serial dilutions(simulating weak anti-A and weak anti-B), weak antibodies (anti-B) in plasma of one normal A-type sample and weak antigens on red blood cells (RBC) of 5 weak D phenotype samples (weak D antigen); (2) Three blood donor samples (type A, O and B) with known UAb were detected by SSM. The results showed that SSM could detect both weak antibodies (anti-A and anti-B) and UAb; (3) SSM was applied to detect the samples of 3 A2B and 3 subtype B blood donors and the blood subtypes could be clearly detected; (4) The number of screening samples was 95,314 and 106,814 before SSM (2018) and after (2020) the application of SSM and the positive rate of UAb (63/95,314 and 187/106,814) increased after SSM, discrepancy of which was statistically significant (χ2 = 48.42, P < 0.01). The above results demonstrate that SSM of ABGA is conducive to the detection of weak agglutination, UAb and blood subtypes in blood samples, which can improve the sensitivity of blood group detection and ensure the safety of clinical blood transfusion to a certain extent.

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Comparative Analysis of Clinical Samples Showing Weak Serum Reaction on AutoVue System Causing ABO Blood Typing Discrepancies

Cited by 7 publications

References 16 publications

Investigation of Discrepant ABO Blood Grouping Results from an Autoanalyzer

Investigation of Discrepant ABO Blood Grouping Results from an Autoanalyzer

ABO blood grouping discrepancies in the donor population

Establishment and application of suspension static method in blood group screening of automated blood group analyzer

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