Detection of red cell antibodies: current and future techniques.

The techniques used routinely in blood group serology for detection of antigen:antibody reactions rely on haemagglutination caused by the ability of antibodies, or antibody:antibody complexes to cross-link with individual cells. The anti-human globulin technique has become the most important test for detecting significant red cell antibodies; however, the classical tube test has been refined to improve speed and sensitivity with the introduction of microtube (column) agglutination and solid-phase methods. Historically, clinical laboratories in the UK have used albumin and/or enzyme methods to support the antiglobulin technique but the cost of these, the insensitivity of albumin techniques, and the doubtful clinical relevance of antibodies detected only by enzyme methods have led to a re-assessment of their value. Although recent innovations employing polybrene and polyethylene glycol have not become widespread in routine practice, the simplicity and sensitivity of microtube and solid-phase methods have ensured that they are becoming the commonly used techniques.