Commissie voor Klinische BiologieCommission de Biologie Clinique
GUIDELINES FOR PRETRANSFUSION TESTING : PART IIQUESTIONNAIRE (n=173 : 84%)
Dr. A. Vanhonsebrouck, Bloedtransfusiecentrum AntwerpenDr. Marjan Van Blerk, WIV hematologie
26-03-2009 WIV CONGRESS
Rue Juliette Wytsmanstraat 14 | 1050 Brussels | BelgiumT +32 2 642 51 11 | F +32 2 642 50 01 | email: [email protected] | www.iph.fgov.be
I. ABO/RH D GROUP (n=173)
I. ABO/RH D GROUP: MANUAL DETERMINATION (n=98)
2 reagents : 48Same : 6Different : 38Not spec. 4
1. ABO/RH D : TYPE OF AUTOMATED EQUIPMENT (n=84)
AUTOMATED EQUIPMENT Number of labs %
Diamed 36 43
Ortho 35 42
Immucor ABS Precis 3 4
Ortho + Diamed 2 2
Biotest Tango 2 2
Immucor Galileo 2 2
Diamed + Immucor Galileo 1 1
Diamed + Immucor ABS Precis 1 1
Biotest Tango + Immucor Galileo 1 1
Diamed reagent on Tecan Freedom EVO Clinical
1 1
I. ABO/RH D: RH D DETERMINATION
Rh D Determination Number Total %1 anti-D reagent 50 132 382 Anti-D reagents 69 132 521 / 2 anti-D reagents 13 132 10DVI neonatus 67 126 53Du determ if Dneg 107 168 64Rh controle 106 160 66Rh subgroups 112 168 67K typing 114 170 67
BLOOD GROUP CARD NUMBER : 112 %1 DETERMINATION 39 34,82 DETERMINATIONS 59 52,7BOTH (temporary/def card) 14 12,5
I. ABO/RH D BLOOD GROUP
AUTOMATED EQ. NUMBER : 84 %
BIDIRECTIONAL with LIS 68 81
1 DETERMINATION 46 57
2 DETERMINATIONS 35 (= 21 reag) 43
SUBGROUP NUMBER : 91 %A and AB 27 30
II. ANTIBODY SCREENING(n=159)
5244
II. ANTIBODY SCREENING TECHNIQUE (n=160)
III. ANTIBODY IDENTIFICATION(n=58)
AUTOMATED EQ 16 %MANUAL 73 %BOTH 10 %
IV. CROSSMATCH TECHNIQUES(n=124)
IV. CROSSMATCHDelivery blood same isogroup (n=113)
VI. CROSSMATCHSELECTION OF BLOOD Women < 45 j Number : 120 %K negative 99 82,5 Rh D negative 120 100Rh subgroups (compatible) 86 73
Presence of antibodies Number : 114 %Ag negative 102 89,5Compatible 12 10,5
IV.CROSSMATCH NEONATUS(n=97)
IV. CROSSMATCH NEONATUS(n=67)
IV. VALIDITY OF CROSSMATCH(n=115)History of transfusion/ Without history of transfusion/pregnancy pregnancy
V. TYPE AND SCREEN(Total answers : 35 out of 128=27,3 %)
METHOD (n= 33) NUMBER %
ELECTRONIC 28
ELECTRONIC+IMM.SPIN 4
IMM SPIN 1
CONTROL BLOOD GROUP(n=35) 34 97
CONTROL ABO/D DONOR UNIT(n=35) 30 86
V. TYPE AND SCREEN : VALIDITY (n=34)
With history of transfusion/ Without history of pregnancy transfusion/pregnancy
VI DAT (n=163)
DAT POLYSPEC.ANTISERA NUMBER %
MANUAL 103 63
AUTOMATED EQ. 47 29
BOTH 13 8
DAT MONOSPEC ANTISERA NUMBER : 62 39
ELUTION 34 27
METHODS PRETRANSFUSION TESTING
Method ABO/DN=193 ABO/D % DAT
N=183DAT
%Antibody Screen
n=178Antibody
%XmatchN=148
Xmatch%
AUTOMATED EQUIPMENT 80 41,5 62 33,9 178 39,3 46 31
Diamed WADIANA ID 36 19 31 17 33 18,5 24 16
Ortho-Clin.Diagn.Autovue 33 17 29 16 32 18 20 13,5
Immucor Galileo 5 2,5 2 1 4 2,2 2 1,5
Immucor ABS Precis 4 2 / / / / / /
Biotest Tango 2 1 / / 1 0,6 / /
MANUAL 113 58,5 121 66 108 60,7 102 69
MANUAL :GEL/COLUMN 66 34 110 60 103 58 97 65,5
Diamed 53 27,5 88 48 88 49,5 76 51,5
Ortho Clin.Diagn. 12 6 21 11,5 14 8 21 14
Biorad 1 0,5 1 0,5 1 0,5 / /
MANUAL : TUBE 40 20,7 10 5,5 4 2,2 4 2,7
Diamed 20 10 1 0,5 1 0,5 / /
Biotest 8 4 2 1 1 0,5 / /
Ortho-Clin.Diagn. 7 3,5 3 1,6 1 0,5 3 2
Immucor 2 1 3 1,6 1 0,5 / /
Biorad/Other 1 0,5 1 0,5 1 0,5 1 0,7
MANUAL : MTP 7 3,6 1 0,5 1 0,5 1 0,7
CONCLUSIONS OF THE QUESTIONNAIREI. ABO/RH D GROUP• If manual determination, more than 1 determination must be
performed on same sample (not for automated equipment )• Blood group card delivery only on 2 different determinations on
2 different samples• RH D Adult : Du determination is not necessary• RH D Neonatus : determination of partial (DVI)/weak D
II-III. ANTIBODY SCREENING/IDENTIFICATION• IAT technique must be included = reference technique• 3 reagent red cells must be used (especially for antigens with
dosage)• More than 1 panel is necessary for exclusion of all antibodies
CONCLUSIONS OF QUESTIONNAIREIV. CROSSMATCH• IAT technique must be performed (enzyme not recommended)• Delivery of blood of same isogroup based on 2 determinations (2 samples)• Neonatus : serum of mother until 4 (3) months (if not available : neonatus)
(big variation of answers)• Validity : with history of transfusion 72 h, but other answers are also
correct but not always practicalwithout history of tranfuison : answers were correct but how canyou be sure of this ?
V. TYPE AND SCREEN• PERFORMED IN 27 % of the laboratories• Control of ABO/Blood group Patient• Control of ABO/Blood group Donor Unit• VALIDITY : 72 h (not longer !)
