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Pooled cells versus individual screening cells in pre-transfusion testing.

M De Silva, M Contreras

    Clinical and Laboratory Haematology
    |January 1, 1985
    PubMed
    Summary

    Using pooled red blood cells for antibody screening in pre-transfusion testing significantly reduces test sensitivity. Individual screening cells are recommended to ensure accurate detection of clinically significant alloantibodies.

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    Area of Science:

    • Transfusion Medicine
    • Immunoserology
    • Blood Banking

    Background:

    • Pre-transfusion antibody screening is crucial for preventing transfusion reactions.
    • The practice of pooling screening red blood cells (RBCs) is common but debated due to potential reduced sensitivity.
    • Limited scientific data exists to definitively support or refute the efficacy of pooled screening cells.

    Purpose of the Study:

    • To comparatively evaluate the sensitivity of antibody screening using pooled versus individual screening RBCs.
    • To provide scientific evidence to resolve the dilemma regarding the optimal method for antibody screening.

    Main Methods:

    • A comparative study was conducted using 105 sera with known weak, warm-reacting clinically significant alloantibodies.
    • Standard sensitive serological techniques were employed.

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  • Both pooled and individual screening RBC samples were tested in parallel for each serum.

    • Main Results:

    • Using pooled screening RBCs resulted in 12% of alloantibodies being undetectable.
    • An additional 23% of alloantibodies were only detectable microscopically with pooled cells.
    • All tested alloantibodies were easily detected macroscopically when using individual screening RBCs.

    Conclusions:

    • The sensitivity of pre-transfusion antibody screening is demonstrably reduced when using pooled screening RBCs.
    • The use of pooled screening RBCs should be discouraged for routine pre-transfusion and antenatal antibody screening.
    • Individual screening RBCs ensure higher sensitivity and macroscopic detectability of clinically significant alloantibodies.