Department of Laboratory Medicine, Ajou University School of Medicine, Suwon, Korea.
Department of Laboratory Medicine, Ajou University Hospital, Suwon, Korea.
Ann Lab Med. 2022 Nov 1;42(6):650-658. doi: 10.3343/alm.2022.42.6.650.
A paucity of studies evaluating failed cases of ABO grouping using autoanalyzers exists. We investigated autoanalyzer rejected cases, including serologically suspicious ABO subgroups and discrepant ABO blood grouping results from Erytra Eflexis (Grifols, Spain), to demonstrate efficient use of autoanalyzers for ABO grouping.
Samples requested for ABO grouping throughout 2020 were tested using two Eflexis instruments and standard ABO RhD and reverse grouping cards. Neonatal cards were not used. When necessary, a conventional tube technique (TUBE) was used to resolve rejected/discrepant Eflexis ABO grouping results.
The overall sample rejection rate (RR) was 3.2% (628/19,466), 1.3% of which were due to various error flags and 1.9% for discrepant results. Cases from neonates ≤1 year old accounted for 35.3% of the rejected cases based on Eflexis results. The ABO groups with the highest and lowest RR (excluding neonates) were A and O, respectively. The 628 samples resulted in 682 rejections, which were frequently associated with reverse grouping, including 28.4% against A and 54.5% for B red cells. Among 14 serologically weakened A and/or B blood groups, six AB and two ABw, which had been missed by Eflexis, were detected using TUBE and our follow-up laboratory criteria.
The ABO group and a proportion of neonatal samples influenced the RR due to weak reverse grouping reactivity, especially toward B red cells. Confirmatory ABO grouping by TUBE in a new patient and/or extra rejection criteria for forward grouping are needed to detect cis-AB, which is relatively common in Korea.
评估自动分析仪检测失败的 ABO 分组病例的研究很少。我们调查了自动分析仪拒收的病例，包括血清学可疑的 ABO 亚型和 Erytra Eflexis（Grifols，西班牙）的不一致 ABO 血型分组结果，以展示自动分析仪在 ABO 分组中的有效应用。
2020 年全年请求进行 ABO 分组的样本使用两台 Eflexis 仪器和标准 ABO RhD 及反向分组卡进行检测。未使用新生儿卡。必要时，采用常规试管技术（TUBE）解决拒收/不一致的 Eflexis ABO 分组结果。
总体样本拒收率（RR）为 3.2%（628/19466），其中 1.3%是由于各种错误标志，1.9%是由于不一致的结果。根据 Eflexis 结果，年龄≤1 岁的新生儿病例占拒收病例的 35.3%。RR 最高和最低的 ABO 组（不包括新生儿）分别为 A 和 O。628 个样本导致 682 个拒收，这经常与反向分组有关，包括 28.4%的 A 型红细胞和 54.5%的 B 型红细胞。在 14 个血清学减弱的 A 和/或 B 血型中，6 个 AB 和 2 个 ABw 被 Eflexis 漏检，使用 TUBE 和我们的后续实验室标准检测到。
ABO 组和一部分新生儿样本由于反向分组反应性较弱而影响 RR，尤其是对 B 型红细胞。在新患者中需要通过 TUBE 进行 ABO 分组的确认，并/或对正向分组制定额外的拒收标准，以检测 cis-AB，这种情况在韩国相对常见。
