Background/Case Studies: Our facility performs approximately 22,000 type and antibody detection tests (ADT) annually with an approximate 2.9% positivity rate for the detection of unexpected antibodies (AB) in patient samples (Specimen). Given the strain on staff due to retirement of seasoned technologists and the impact of COVID, we sought to evaluate the efficiency of the red blood cell (RBC) panels used for antibody identification (ABID), to determine the frequency antigen typing/selected cells (Ag typing/selected cells) are required for ABID and to establish a policy for when specimens should be referred to the reference laboratory.
Study
Design/Methods: A retrospective review was performed for all 635 ABID workups performed in 2022. Records were reviewed for the number and type of RBC panels utilized in the ABID as well as whether the work-up required the use of antigen negative screening or selected cells and/or those sent to a reference laboratory for ABID.
Results/Findings: Of the 635 ABID workups evaluated, anti-D due to the administration of Rh immune globulin was the most frequent cause of a positive antibody detection test 26%, (163). Other overall samples (14%) included: send out, anti-CD38, Cold/Warm autoantibodies, inconclusive or a negative panel.
For those specimens tested in-house with a single antibody specificity, 84% (398) required only one ABID panel, while 98% were identified using one or two ABID panels (Table 1). For those specimens tested in-house with multiple antibody specificities (76), 97% were identified using only 1 or 2 panels. Capture-R Ready-ID Extend II was the most frequently used panel followed by Capture-R Ready-ID. Overall, of 635 specimens, only 2.8% required Ag typing/selected cells. Conclusions: Through this study we acknowledge that not all antibodies maybe identified in-house, and a small percentage need Ag typing/Select cells for ABID. In-house RBC panels used for antibody identification (ABID) we found to be highly efficient, considering 97% of the single and multiple antibodies were identified using only 1 or 2 panel(s) resulting in less tech labor. Few antibodies required the additional cost of send outs.
Importance of research: Given the strain on staff we sought to evaluate the efficiency of the red blood cell panels used for antibody identification, to determine the frequency antigen typing/selected cells are required, while establishing a policy for when specimens should be referred to the reference laboratory. Records were reviewed from the previous year, for the number and type of RBC panels utilized in the analysis as well as whether the work-up required the use of antigen negative screening or selected cells.
