Kokoris Styliani I, Kalantzis Dimitrios, Moschandreou Dimitra, Papaioannou Konstantina, Grouzi Elisavet
Laboratory of Hematology and Hospital Blood Transfusion Department, Medical School, University General Hospital 'Attikon', National and Kapodistrian University of Athens, Chaidari, Greece.
Department of Transfusion Service and Clinical Hemostasis, 'Saint Savvas' Oncology Hospital, Athens, Greece.
Asian J Transfus Sci. 2022 Jul-Dec;16(2):257-262. doi: 10.4103/ajts.ajts_133_20. Epub 2022 Sep 28.
Panagglutination on the indirect antiglobulin test is one of the most challenging dilemmas of pretransfusion testing. It occurs when patient sera react with all red blood cells tested, that is, with both screening and identification panel cells. Two main questions must be answered. The first is to determine whether panagglutination results from the presence of autoantibody and/or alloantibody (single alloantibody or multiple alloantibodies or antibody to high-incidence antigen). The second problem is to detect the possible concomitant presence of clinically significant alloantibodies masked by panagglutination. The purpose of this mini-review is to describe the situations that can cause panagglutination and to develop algorithms which can resolve the problem. The two main points in the evaluation of panagglutination involve the assessment of the intensity of reactivity with the reagent red cells used and whether the autocontrol is positive or not. It is imperative to understand the laboratory results and the techniques available that guide the investigative process.
间接抗球蛋白试验中的全凝集是输血前检测中最具挑战性的难题之一。当患者血清与所有检测的红细胞发生反应时，即与筛查细胞和鉴定细胞面板都发生反应时，就会出现全凝集。必须回答两个主要问题。第一个问题是确定全凝集是由自身抗体和/或同种抗体（单一同种抗体、多种同种抗体或针对高频抗原的抗体）的存在引起的。第二个问题是检测可能同时存在的被全凝集掩盖的具有临床意义的同种抗体。本综述的目的是描述可能导致全凝集的情况，并开发能够解决该问题的算法。评估全凝集的两个要点包括评估与所用试剂红细胞的反应强度，以及自身对照是否呈阳性。必须了解指导调查过程的实验室结果和可用技术。
