Comparison of ABO isoagglutinin titres by three different methods in group O blood donors

Abstract

Background and aims Antibody titration by the manual method has certain limitations. The aim of this study was to compare the manual conventional test tube technique (CTT) with semi-automated, column agglutination technique (CAT) and fully automated haemagglutination/solid-phase red cell adherence (HA/SPRCA) technology in measuring antibody titres of anti-A and anti-B isoagglutinins of blood group O blood donors. The median IgM and IgG antibody titres with 1+, 2+ and 3+ end-points were determined for each technology, and the agreement and correlation between results of the 3 technologies were evaluated.Materials and methods This was a prospective, observational study conducted from October 2018 to March 2020. All consecutive O group blood donors, who donated blood at the Department of Transfusion Medicine at a tertiary healthcare centre, were included in the study. All samples were consecutively tested by CTT, CAT and HA/SPRCA, and the results were recorded and compared.Results A total of 2005 donors were included. Inter-observer variation was observed in 295 (14.71%) samples by the CTT and in 51 (2.54%) by the CAT. There was 43.4% and 40.3% agreement of anti-A IgM and IgG titres between CAT (2+ strength) and CTT (1+ strength), respectively. The agreement for anti-B IgM and IgG titres between CAT (2+ strength) and CTT (1+ strength) was 43.6% and 32%, respectively. While a strong correlation was found between CTT (1+ strength) and CAT (1+, 2+ strengths) for both IgM and IgG measurements of anti-A and anti-B isoagglutinins, the correlation between CTT (1+ strength) and HA/SPRCA (1+, 2+ strengths) was found to be weak. The median IgM titres for anti-A and anti-B were lower than the median IgG titres. ConclusionThe antibody titration levels were higher with CAT than with CTT, and those of HA/SPRCA were lower than those of CTT. Transfusion services need to decide which method would provide higher benefit to their patient population.

Feasibility of the automated column agglutination technique for titration of anti‐A/B antibodies in ABO‐incompatible living kidney transplantation

“…The concordance rate and CACR of the two methods were 60.4% and 88.3%, respectively. In a previous study, Pandey et al reported the concordance rate of IgM and IgG between TT and CAT as 43.4% and 40.3%, respectively 18 . In addition, Datta et al reported a concordance rate of 48% when DTT treated plasma for IgG antibody titer 19 .…”

“…In a previous study, Pandey et al reported the concordance rate of IgM and IgG between TT and CAT as 43.4% and 40.3%, respectively. 18 In addition, Datta et al reported a concordance rate of 48% when DTT treated plasma for IgG antibody titer. 19 Based on this study and previous reports, the concordance rate between the two methods is likely to be around 40%-60%.…”

Laboratory support of ABO antibody monitoring for ABO-incompatible solid organ transplantation

“…However, titration has several inherent limitations. It has not been standardized, and there are significant interobserver and interlaboratory variations [ 12 , 13 ]. Titration techniques are different among laboratories in terms of whether they use the tube or CAT method, as well as according to whether they measure IgM or IgG [ 7 , 14 ].…”

A New Trial to Measure ABO Antibodies Using Complement-Dependent Cytotoxicity

“…ABO Ab titration test has some inherent flaws. It has not been standardized yet, and there are significant interobserver and interlaboratory variations [5,10]. Titration techniques used presently are different among laboratories-e.g., tube vs. column, IgM vs. IgG [11,12].…”