Jo Su Yeon, Lee Ju Mi, Kim Hye Lim, Sin Kyeong Hwa, Lee Hyeon Ji, Chang Chulhun Ludgerus, Kim Hyung Hoi
Department of Laboratory Medicine, School of Medicine, Pusan National University, Medical Research Institute, Pusan National University Yangsan Hospital, Yangsan, Korea.
Department of Laboratory Medicine, School of Medicine, Pusan National University, Medical Research Institute, Pusan National University Hospital, Busan, Korea.
Ann Lab Med. 2017 Mar;37(2):117-123. doi: 10.3343/alm.2017.37.2.117.
ABO blood typing in pre-transfusion testing is a major component of the high workload in blood banks that therefore requires automation. We often experienced discrepant results from an automated system, especially weak serum reactions. We evaluated the discrepant results by the reference manual method to confirm ABO blood typing.
In total, 13,113 blood samples were tested with the AutoVue system; all samples were run in parallel with the reference manual method according to the laboratory protocol.
The AutoVue system confirmed ABO blood typing of 12,816 samples (97.7%), and these results were concordant with those of the manual method. The remaining 297 samples (2.3%) showed discrepant results in the AutoVue system and were confirmed by the manual method. The discrepant results involved weak serum reactions (<2+ reaction grade), extra serum reactions, samples from patients who had received stem cell transplants, ABO subgroups, and specific system error messages. Among the 98 samples showing ≤1+ reaction grade in the AutoVue system, 70 samples (71.4%) showed a normal serum reaction (≥2+ reaction grade) with the manual method, and 28 samples (28.6%) showed weak serum reaction in both methods.
ABO blood tying of 97.7% samples could be confirmed by the AutoVue system and a small proportion (2.3%) needed to be re-evaluated by the manual method. Samples with a 2+ reaction grade in serum typing do not need to be evaluated manually, while those with ≤1+ reaction grade do.
输血前检测中的ABO血型鉴定是血库高工作量的主要组成部分，因此需要自动化操作。我们经常遇到自动化系统得出的结果不一致的情况，尤其是血清反应较弱的时候。我们通过参考手工方法对不一致的结果进行评估，以确认ABO血型。
总共用AutoVue系统检测了13113份血样；所有样本均按照实验室规程与参考手工方法并行检测。
AutoVue系统确认了12816份样本（97.7%）的ABO血型，这些结果与手工方法的结果一致。其余297份样本（2.3%）在AutoVue系统中显示结果不一致，并通过手工方法得到确认。不一致的结果包括血清反应较弱（反应等级<2+）、额外的血清反应、接受过干细胞移植患者的样本、ABO亚型以及特定的系统错误信息。在AutoVue系统中显示反应等级≤1+的98份样本中，70份样本（71.4%）用手工方法检测时血清反应正常（反应等级≥2+），28份样本（28.6%）在两种方法中均显示血清反应较弱。
AutoVue系统可以确认97.7%样本的ABO血型，一小部分（2.3%）需要通过手工方法重新评估。血清分型中反应等级为2+的样本无需手工评估，而反应等级≤1+的样本则需要。
