Sallander S, Shanwell A, Aqvist M
Stockholm Blood Transfusion Service, Södersjukhuset, Sweden.
Vox Sang. 1996;71(4):221-5. doi: 10.1046/j.1423-0410.1996.7140221.x.
We have studied a previously described solid-phase test (SPH) for screening and identification of antibodies directed against erythrocyte antigens, in large sample numbers and throughout routine processing. The screening results of all samples from pregnant women, patients and blood donors (n = 36,701) sent to our blood bank from August 1992 to July 1993 were compiled and evaluated. Pregnant women were screened by the SPH-antiglobulin technique (IAT) and the SPH-enzyme-enhanced technique (ENZ), while the patients and blood donors were screened only by the SPH-IAT. Samples with known alloimmunization were excluded from this study. Positive screening reactions were further investigated by the SPH-IAT and SPH-ENZ techniques, the manual hemagglutination tests low ionic-strength solution IAT and 2-stage papain. Pregnant women: A positive reaction in one or both of the SPH tests was found in 1.2% of the samples. The SPH tests identified 99 (98.0%) and the manual methods 79 (78.2%) of a total of 101 antibodies. Of the identified antibodies, 61 were to antigens in the Rh blood group system, including 34 Rh immune globulin. The remainder had specificity directed against antigens K, Jka, M, S, Le(a) and Le(b).
A positive reaction in the SPH-IAT test occurred in 0.9% of the samples. The antibodies identified had specificity directed against antigens D, C, c and E in the Rh blood group system. The remainder had specificity directed against antigens Fya, K, Jka, M and Le(a). All antibodies identified by SPH-IAT, except 1 anti-M and 2 anti-Le(a), were also identified by manual methods. Blood donors: A positive reaction in the SPH-IAT test was noted in 0.7% of the samples. The identified antibodies had specificity directed against antigens D, C, E, Fya, K and M. All antibodies identified by the SPH-IAT, except 1 anti-D found in a sample from an RhD(+) male, were also identified by the manual methods. This study indicates that the SPH-IAT test is sensitive for detecting anti-M. This was also indicated for the SPH-ENZ test concerning the Jka antibody. An advantage of using solid-phase antibody screening tests for a larger series of samples is the possibility of automated sample identification, dilution, dispensing and interpretation of results. The SPH-IAT and the SPH-ENZ tests permitted us to select test cells, preferably from our own donor pool. We conclude that the SPH-IAT and SPH-ENZ tests are suitable for routine antibody screening of pregnant women and the SPH-IAT test for screening patients and blood donors.
我们对一种先前描述的用于筛选和鉴定针对红细胞抗原的抗体的固相试验（SPH）进行了研究，样本数量众多且涵盖整个常规检测过程。收集并评估了1992年8月至1993年7月送至我们血库的所有孕妇、患者和献血者样本（n = 36,701）的筛选结果。孕妇通过SPH抗球蛋白技术（IAT）和SPH酶增强技术（ENZ）进行筛选，而患者和献血者仅通过SPH-IAT进行筛选。本研究排除了已知同种免疫的样本。通过SPH-IAT和SPH-ENZ技术、手工血凝试验低离子强度溶液IAT和两阶段木瓜蛋白酶试验对阳性筛选反应进行进一步研究。
在1.2%的样本中，一项或两项SPH试验出现阳性反应。在总共101种抗体中，SPH试验鉴定出99种（98.0%），手工方法鉴定出79种（78.2%）。在鉴定出的抗体中，61种针对Rh血型系统中的抗原，包括34种Rh免疫球蛋白。其余抗体针对K、Jka、M、S、Le(a)和Le(b)抗原具有特异性。
在0.9%的样本中，SPH-IAT试验出现阳性反应。鉴定出的抗体针对Rh血型系统中的D、C、c和E抗原具有特异性。其余抗体针对Fya、K、Jka、M和Le(a)抗原具有特异性。除1种抗-M和2种抗-Le(a)外，SPH-IAT鉴定出的所有抗体也通过手工方法鉴定出来。
在0.7%的样本中，SPH-IAT试验出现阳性反应。鉴定出的抗体针对D、C、E、Fya、K和M抗原具有特异性。除在一名RhD(+)男性样本中发现的1种抗-D外，SPH-IAT鉴定出的所有抗体也通过手工方法鉴定出来。本研究表明，SPH-IAT试验对检测抗-M敏感。对于Jka抗体，SPH-ENZ试验也有此表现。使用固相抗体筛选试验检测大量样本的一个优点是有可能实现样本自动识别、稀释、加样和结果判读。SPH-IAT和SPH-ENZ试验使我们能够选择检测细胞，最好从我们自己的供者库中选取。我们得出结论，SPH-IAT和SPH-ENZ试验适用于孕妇的常规抗体筛选，SPH-IAT试验适用于患者和献血者的筛选。
