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The evolution of pretransfusion testing: from agglutination to solid-phase red cell adherence tests.
F V Plapp1, L T Sinor, J M Rachel
1Clinical Pathology Department, St. Luke's Hospital, Kansas City, Missouri.
Critical Reviews in Clinical Laboratory Sciences
|January 1, 1989
Summary
Solid-phase red cell adherence assays offer an objective endpoint for blood testing, improving upon manual hemagglutination methods. These assays enable automated, accurate results for various serological procedures in transfusion services and blood centers.
Area of Science:
- Clinical Pathology
- Immunology
- Biotechnology
Background:
- Manual hemagglutination tests are standard in hospital transfusion services and blood centers.
- Automation of hemagglutination is challenging due to the lack of objective, easily interpretable endpoints.
- Existing methods often require specialized equipment for accurate result interpretation.
Purpose of the Study:
- To introduce and evaluate solid-phase red cell adherence assays as an alternative to manual hemagglutination.
- To demonstrate the versatility of solid-phase assays for a wide range of serological tests.
- To highlight the potential for improved objectivity and automation in blood testing.
Main Methods:
- Development and application of solid-phase red cell adherence assays.
- Testing included ABO cell and serum grouping, Rh typing, antibody screening (red cell and platelet), crossmatching (red cell and platelet), IgA deficiency screening, and infectious disease screening (HBsAg, HIV).
- Assays utilize an objective endpoint of indicator red cell adherence, interpretable visually, spectrophotometrically, or via image analysis.
Main Results:
- Solid-phase red cell adherence assays demonstrate performance comparable to current hemagglutination and enzyme immunoassay methods.
- The common objective endpoint allows for consistent and straightforward result interpretation.
- Microplate formats are suitable for high-throughput batch processing, while dipstick formats allow for individual sample testing outside the lab.
Conclusions:
- Solid-phase red cell adherence assays provide a reliable and objective alternative to manual hemagglutination for numerous blood banking procedures.
- The objective endpoint facilitates automation and potentially revolutionizes the interpretation of agglutination tests.
- These assays offer flexibility in format, supporting both large-scale laboratory testing and point-of-care applications.