Herter L, Weingart C, Merten N, Bock N, Kohn B
Klein- und Heimtierklinik, Fachbereich Veterinärmedizin, Freie Universität Berlin.
Schweiz Arch Tierheilkd. 2025 Feb;167(2):109-119. doi: 10.17236/sat00345.
Cross-matching is used to determine the serological compatibility of donor and recipient blood. This procedure is used to detect possible antibodies against the donor's erythrocytes, thereby reducing the risk of immunological transfusion reactions. Various methods are available for cross-matching: In addition to the tube agglutination method, which is often viewed as a reference method, gel and immunochromatographic methods are available. In this study, a gel tube method, an antiglobulin-enhanced gel tube method, and an immunochromatographic method were evaluated in comparison to the tube agglutination method in 28 different major cross-matches. The evaluation resulted in 85,7 % agreement between the antiglobulin-enhanced gel tube method, in 60,7 % agreement between the gel tube method and in 35,7 % agreement between the immunochromatographic method and the tube agglutination method. Considering the macroscopically positive test results alone, the agreement between the tube agglutination method and the antiglobulin-enhanced gel tube method was 100 %, the gel tube method 62,5 % and with the immunochromatographic 0 %. Using the antiglobulin-enhanced gel tube method, 4/9 weakly positive cross-matches, which were positive with a microscopic degree of agglutination of 1+ - 2+ using the tube agglutination method, were compatible. In all other cross-matches with a higher degree of agglutination, the results were consistent with those of the tube agglutination method. Transfusion of incompatible blood products may result in hemolytic transfusion reactions. However, the clinical relevance of microscopically weakly positive cross-matches is unclear. The application of the various test kits took significantly less time compared to the tube agglutination procedure. Due to the strong agreement and reduction in required time, the antiglobulin-enhanced gel tube method offers a good alternative to the reference method, especially in emergency situations. On the other hand, there was only a weak agreement between the gel tube and no agreement between the immunochromatographic method and the reference method.
交叉配血用于确定供体和受体血液的血清学相容性。该程序用于检测针对供体红细胞的可能抗体,从而降低免疫输血反应的风险。交叉配血有多种方法:除了常被视为参考方法的试管凝集法外,还有凝胶法和免疫层析法。在本研究中,对28种不同的主要交叉配血,将凝胶试管法、抗球蛋白增强凝胶试管法和免疫层析法与试管凝集法进行了比较评估。评估结果显示,抗球蛋白增强凝胶试管法与试管凝集法的符合率为85.7%,凝胶试管法与试管凝集法的符合率为60.7%,免疫层析法与试管凝集法的符合率为35.7%。仅考虑宏观阳性检测结果,试管凝集法与抗球蛋白增强凝胶试管法的符合率为100%,凝胶试管法为62.5%,与免疫层析法为0%。使用抗球蛋白增强凝胶试管法时,9例使用试管凝集法显微镜凝集度为1+-2+呈弱阳性的交叉配血中有4例是相容的。在所有其他凝集度较高的交叉配血中,结果与试管凝集法一致。输注不相容的血液制品可能会导致溶血性输血反应。然而,显微镜下弱阳性交叉配血的临床相关性尚不清楚。与试管凝集程序相比,各种检测试剂盒的应用时间明显缩短。由于符合率高且所需时间减少,抗球蛋白增强凝胶试管法为参考方法提供了一个很好的替代方案,尤其是在紧急情况下。另一方面,凝胶试管法与参考方法之间的符合率较低,免疫层析法与参考方法之间则无符合率。