Lown J A, Barr A L, Jackson J M
Pathology. 1985 Jul;17(3):489-92. doi: 10.3109/00313028509105506.
In recent years, experience with screening protocols for the detection of red cell antibodies has led to a reappraisal of pre-transfusion testing procedures. In the U.S.A. in particular, it has become accepted practice to perform only an antiglobulin crossmatch when an antibody screen has been negative. There is now debate in that country regarding the necessity of retaining even the antiglobulin crossmatch. In this laboratory, as is usual in Australia, room temperature, enzyme and antiglobulin tests are used for both antibody screening and crossmatching. A review was therefore conducted of the results of screening 58,227 samples from approximately 40,000 patients, involving 126,771 crossmatched blood units over a 53 mth period. Eight hundred and seventy-two red cell antibodies were detected in 718 patients. Forty-four of these antibodies were detected only in the crossmatch, and of these 23 were of potential clinical significance. Fourteen of the 23 were detected by the antiglobulin test, 8 by an enzyme test and only 1 by the saline method. Of 107 antibodies detected only in the room temperature phase, none were of clinical significance. The results indicate that exclusion of room temperature tests from all pre-transfusion testing, and deletion of enzyme tests from the crossmatch will not compromise patient safety.
近年来，红细胞抗体检测筛查方案的经验促使人们对输血前检测程序进行重新评估。特别是在美国，当抗体筛查呈阴性时，仅进行抗球蛋白交叉配血已成为公认的做法。目前该国正在就是否有必要保留抗球蛋白交叉配血展开辩论。在本实验室，与澳大利亚的常规做法一样，室温试验、酶试验和抗球蛋白试验用于抗体筛查和交叉配血。因此，对53个月内从约40000名患者中筛查的58227份样本的结果进行了回顾，涉及126771个交叉配血的血液单位。在718名患者中检测到872种红细胞抗体。其中44种抗体仅在交叉配血中检测到，其中23种具有潜在临床意义。23种中的14种通过抗球蛋白试验检测到，8种通过酶试验检测到，仅1种通过盐水法检测到。在仅在室温阶段检测到的107种抗体中，没有一种具有临床意义。结果表明，在所有输血前检测中排除室温试验，以及在交叉配血中删除酶试验不会危及患者安全。
