Droplet-based blood group antibody screening with laser incubation

Detection of blood group antibodies is a crucial step for blood transfusion recipients and pregnant women to prevent potentially fatal haemolytic reactions. Due to the short, non-bridging structure of such antibodies (IgG), the indirect antiglobulin test (IAT) is required, complete with a thermal incubation phase. This incubation step, where the sample must be heated to 37 °C for several minutes, has hitherto prevented chip- and paper-diagnostics from performing a complete IAT and instead required the IAT to be performed away from the patient beside in a laboratory setting with specialist equipment - significantly delaying blood transfusions. With recent laser technology for immunohaematology, a single blood droplet can be heated. This study presents a simple diagnostic where a single 15 μL droplet sits on hydrophobic PTFE film and is heated by laser. The result of the test is then determined via placement of a paper strip where passive wicking and filtration of the sample separates positive from negative results. We demonstrate that this diagnostic can accurately and sensitively detect blood group antibodies, with results quickly read by eye without further specialist equipment or training, with potential to lead to a point-of-care antibody screen.