Critical evaluation of donor direct antiglobulin test positivity: Implications in cross-matching and lessons learnt

Puri, Vandana; Chhikara, Aruna; Sharma, Garima; Sehgal, Shivali; Sharma, Sunita

doi:10.4103/ajts.ajts_125_17

Cited by 3 publications

(3 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These can miss DATpositive donor units unless DAT screening of donors is included in pre-transfusion testing. Similar cases of incompatible crossmatch due to DAT-positive donors were reported by Puri et al and Vidushi et al [6,8]. However, DAT positivity has been reported in 0.008% of donors [9].…”

Section: Discussionsupporting

confidence: 68%

Evaluation of Incompatible Crossmatches at a Tertiary Care Hospital in Chennai – A Prospective Study

et al. 2024

Asian J Pharm Clin Res

View full text Add to dashboard Cite

Objectives: The primary goal in blood transfusion is that the transfused blood unit be compatible with the patient during crossmatching. This compatibility testing is performed before every administration of blood component. This cross-matching test helps to detect the presence of antibodies in the recipient against antigens over red blood cells of donor. The aim of this study was to evaluate the incidence and causes of in compatible crossmatches in patients by tube agglutination method. Methods: This was a retrospective cross-sectional study conducted by analyzing incompatible crossmatches encountered during routine compatibility testing between January and December 2021 at the Department of Transfusion Medicine, Government Kilpauk Medical College and Hospital, Chennai, Tamil Nadu, India. The analysis was done in March and April 2022. All crossmatches were done by tube agglutination technique. Data were entered in Microsoft Excel and analyzed. Descriptive statistics were given in summary statistics. Results: Out of the total of 12943 crossmatches performed, 0.3% (n=39/12943) were incompatible. About 76.9% (n=30/39) were seen in females while 69.2% (n=27/39) were seen in the age group 20–60 years. About 35.9% (n=14/39) of the incompatible crossmatches were due to autoimmune hemolytic anemia (AIHA). A root cause analysis protocol was formulated to resolve the incompatibility and ensure safe transfusion. Conclusion: AIHA was the most common cause of incompatible crossmatch. The root cause analysis protocol involves a thorough evaluation of the patient’s clinical condition, underlying pathology, and errors during technical procedure to identify the cause of incompatibility. Protocols should be developed in each blood center and a logical stepwise approach will enable the provision of safe transfusion.

show abstract

Section: Discussionsupporting

confidence: 68%

Evaluation of Incompatible Crossmatches at a Tertiary Care Hospital in Chennai – A Prospective Study

et al. 2024

Asian J Pharm Clin Res

View full text Add to dashboard Cite

show abstract

“…[ 9 ] Antibody in the majority of such donors, including that in the present study, showed the immunoglobulin subclass as IgG1 which is otherwise known to cause clinical hemolysis, yet remained innocuous for unknown reasons. Many times, such healthy donors with positive DAT are noticed during crossmatch tests in the antiglobulin phase[ 1 10 ] as was the case with our donor.…”

Section: Discussionmentioning

confidence: 84%

An autoantibody to Rh-Ce protein causing positive direct antiglobulin test in a healthy blood donor

Joshi,

Parikh,

Vekariya

et al. 2023

Asian J Transfus Sci

View full text Add to dashboard Cite

A positive direct antiglobulin test (DAT) is of diagnostic feature for the patient with autoimmune hemolytic anemia (AIHA). However, on rare occasions, for obscure reasons, it is found among healthy blood donors. The present report is aimed to elucidate serological and immunological characteristics of such autoantibody in a healthy donor aged 62 years found with positive DAT. There was no history of Leishmaniasis, nor having a significant illness. His red blood cells (RBCs) showed incompatible cross-match results with every recipient tested in the antiglobulin phase. He was found to be DAT+. As his plasma had very little presence of autoantibody, hence was augmented by elution from his in vivo sensitized RBCs for the study. Autoantibody with immunoglobulin IgG showed predominant specificity of anti-Ce. It is certainly a rare case of autoantibody to RhCe compound antigen yet being innocuous in a healthy blood donor with a positive DAT.

show abstract

“…There are no data on adverse consequences of transfusion of DAT‐positive blood. Institutions that use only saline phase cross‐match or computerized cross‐match cannot detect DAT‐positive units in this way, so it happens that such units are used in patients [11]. Based on literature data, IgG‐coated erythrocytes are not expected to have reduced survival after transfusion [12].…”

Section: Discussionmentioning

confidence: 99%

Direct antiglobulin test positivity in Serbian blood donors in the era of gel card technology

et al. 2023

View full text Add to dashboard Cite

Background and Objectives: In the era of gel cards, we aimed to determine the incidence of a positive direct antiglobulin test (DAT) in a population of blood donors in Serbia and to compare results with the period when a conventional tube technique was used. Materials and Methods:A retrospective study was conducted on 184,171 blood donors over 10 years (2012)(2013)(2014)(2015)(2016)(2017)(2018)(2019)(2020)(2021). Positive DAT results initially were detected after positive result of the compatibility test. After a DAT had been initially performed on fresh blood samples, a control DAT was performed 6 months later.Results: Using gel cards, we found a low incidence (0.09%) of DAT positivity among 55,254 female and 128,917 male blood donors, with no difference found in the occurrence of a positive DAT between them. Positive DAT moderately positively correlated with increasing age of blood donors, but without statistical significance.The vast majority of blood donors (98.86%) were IgG positive. All donors were in good health, did not take medication or had anaemia or haemolysis. During the period 1980-1989, when the test tube technique was used, we found 0.05% DAT-positive blood donors. Conclusion:The incidence of positive DAT results in Serbian blood donors is higher compared with that found using the previous test tube technique, but the incidence is consistent with the findings of other studies.

show abstract

Critical evaluation of donor direct antiglobulin test positivity: Implications in cross-matching and lessons learnt

Cited by 3 publications

References 7 publications

Evaluation of Incompatible Crossmatches at a Tertiary Care Hospital in Chennai – A Prospective Study

Evaluation of Incompatible Crossmatches at a Tertiary Care Hospital in Chennai – A Prospective Study

An autoantibody to Rh-Ce protein causing positive direct antiglobulin test in a healthy blood donor

Direct antiglobulin test positivity in Serbian blood donors in the era of gel card technology

Contact Info

Product

Resources

About