A microplate system for ABO and Rh(D) blood grouping

Area of Science:

• Transfusion Medicine
• Clinical Laboratory Science

Background:

• Automated blood grouping systems are crucial for efficient and accurate blood type determination in transfusion medicine.
• Manual methods for ABO and Rh(D) grouping can be time-consuming and prone to errors.
• Evaluating new automated systems is essential for improving laboratory workflows and patient safety.

Purpose of the Study:

• To describe and evaluate the performance of a novel microplate system for ABO and Rh(D) blood group determinations.
• To compare the accuracy and efficiency of the microplate system against established automated and manual blood grouping techniques.

Main Methods:

• A microplate system integrating a Kemble Kemtek 1000SP liquid handler, Anthos 2001 microplate reader, and Sanguin Forma software was utilized.
• The system was evaluated using 10,042 routine blood donor samples, with parallel testing against a Technicon AutoAnalyzer.
• Manual techniques were employed for ABO reverse groupings, discrepancy resolution, and confirmation of D-negative results via indirect antiglobulin testing.

Main Results:

• The microplate system achieved a 97.3% correct grouping rate for ABO and Rh(D) across 10,042 samples.
• 266 samples (2.6%) were flagged with 'no type determined' (124 for ABO, 142 for Rh).
• An additional 30 weak D samples, missed by both automated systems, were identified using manual indirect antiglobulin tests.

Conclusions:

• The described microplate system offers a flexible, maintainable, and operable solution for ABO and Rh(D) blood grouping.
• The system demonstrates high accuracy and potential for improving efficiency in blood donor screening.
• Complementary manual testing remains important for resolving discrepancies and detecting weak D variants.