Orlando Nicoletta, Bianchi Maria, Valentini Caterina Giovanna, Maresca Maddalena, Massini Giuseppina, Putzulu Rossana, Zini Gina, Teofili Luciana
Istituto di Ematologia, Università Cattolica del Sacro Cuore - Fondazione Policlinico Universitario A. Gemelli, Rome, Italy.
Transfus Med Hemother. 2018 May;45(3):179-183. doi: 10.1159/000484570. Epub 2018 Mar 6.
The detection of irregular antibody is a critical issue in the management of red blood cell transfusion according to the Type & Screen (T&S) practice. In order to implement the T&S procedure at our blood bank, we compared three different automated analyzers based on column agglutination technique (CAT) or solid phase red cell adherence assay (SPACA) methods.
Pre-transfusion antibody screening was performed in 986 patients candidate to elective surgery at low risk for red blood cell transfusion. We tested the following kits: the three-cell panel micro-CAT system ID-DiaCell I-II-III (DiaMed), the four-cell panel solid-phase system Capture-R Ready Screen-4 (Immucor), and the four-cell panel micro-CAT system Serascan Diana-4 (Grifols). Positive results were further investigated using corresponding identification panels, and discrepant results were investigated with all the antibody identification systems.
Among 986 samples, we observed 967 concordant negative results (98.1%), 8 concordant positive results (0.8% of cases), and 11 discrepant results (1.1%). Among discrepant samples, an alloantibody could been identified in two patents (anti-M, detected by Serascan Diana-4 and ID-DiaCell I, II, III; anti-Kp, detected by Capture-R Ready Screen-4 and Serascan Diana-4).
Among the evaluated technologies, the four-cell panel micro-CAT system displayed the highest sensitivity and specificity with an optimal negative predictive value. These features might be relevant to the routine implementation of the T&S transfusion strategy.
根据血型筛查（T&S）操作规范，不规则抗体的检测是红细胞输血管理中的关键问题。为了在我们的血库实施T&S程序，我们比较了三种基于柱凝集技术（CAT）或固相红细胞粘附试验（SPACA）方法的不同自动分析仪。
对986例择期手术且红细胞输血风险较低的患者进行输血前抗体筛查。我们测试了以下试剂盒：三细胞微柱凝集系统ID-DiaCell I-II-III（DiaMed公司）、四细胞固相系统Capture-R Ready Screen-4（Immucor公司）和四细胞微柱凝集系统Serascan Diana-4（Grifols公司）。阳性结果使用相应的鉴定板进一步研究，结果不一致的样本则使用所有抗体鉴定系统进行研究。
在986份样本中，我们观察到967份结果一致为阴性（98.1%），8份结果一致为阳性（占病例的0.8%），11份结果不一致（1.1%）。在结果不一致的样本中，在两名患者中鉴定出同种抗体（抗-M，由Serascan Diana-4和ID-DiaCell I、II、III检测到；抗-Kp，由Capture-R Ready Screen-4和Serascan Diana-4检测到）。
在评估的技术中，四细胞微柱凝集系统显示出最高的敏感性和特异性，阴性预测值最佳。这些特性可能与T&S输血策略的常规实施有关。
