ImmunohematologyPub Date : 2023-12-29eCollection Date: 2023-12-01DOI: 10.2478/immunohematology-2023-025
S Sawadogo, K Nebie, D Kima, S K A Ouedraogo, P A Nagnon, J Koulidiati, C Traore, S Sawadogo, E Kafando, V Deneys
{"title":"Feasibility and performance of in-house red blood cell reagents to detect unexpected antibodies in immunized patients in Burkina Faso.","authors":"S Sawadogo, K Nebie, D Kima, S K A Ouedraogo, P A Nagnon, J Koulidiati, C Traore, S Sawadogo, E Kafando, V Deneys","doi":"10.2478/immunohematology-2023-025","DOIUrl":"10.2478/immunohematology-2023-025","url":null,"abstract":"<p><p>In sub-Saharan Africa, antibody detection tests remain inaccessible because of the high cost and limited shelf life of red blood cell (RBC) reagents. This study aimed at investigating the feasibility and performance of locally prepared RBC reagents for antibody detection in Burkina Faso. We conducted an experimental study comparing commercial RBC panels and a local panel prepared from phenotyped blood donors in Ouagadougou, Burkina Faso. Antibody detection testing was performed by the indirect antiglobulin test using a gel card filtration column in a low-ionic-strength solution. Judgment criteria were the concordance rate and the kappa agreement coefficient of results generated by the two panels. A total of 302 blood donors were phenotyped for the major antigens of the RH, KEL, MNS, FY, JK, LE, and P1PK blood group systems. From this pool of donors, we designed an RBC detection panel that was used to screen for unexpected antibodies in 1096 plasma samples from 832 patients with a history of transfusion and 264 recently delivered or pregnant women with no history of blood transfusion. A positive antibody detection test was observed in 8.1 percent of the samples using the local panel versus 6.4 percent with the commercial panels. A total of 23 samples were negative with the commercial panels and positive with the local panel, while the findings were reversed for four samples. The concordance rate was 97.5 percent, and the kappa agreement coefficient was 0.815. Our results suggest that the development of local RBC panels can be an alternative to commercial panels in countries with limited resources. It could also be a cost-effective intervention, mainly for children under 5 years of age, women of childbearing age, and pregnant women, all of whom are most at risk for malaria and sickle cell disease complications. Blood services could develop and implement appropriate strategies to make phenotyped donor pools available for the design of suitable RBC panels.</p>","PeriodicalId":13357,"journal":{"name":"Immunohematology","volume":"39 4","pages":"172-180"},"PeriodicalIF":0.0,"publicationDate":"2023-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139097754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
ImmunohematologyPub Date : 2023-12-29eCollection Date: 2023-12-01DOI: 10.2478/immunohematology-2023-022
J T Little, D P Blackall
{"title":"Evaluation of solid-phase panreactivity with negative direct antiglobulin testing.","authors":"J T Little, D P Blackall","doi":"10.2478/immunohematology-2023-022","DOIUrl":"10.2478/immunohematology-2023-022","url":null,"abstract":"<p><p>Solid-phase red cell adherence (SPRCA) is a sensitive platform for antibody detection, but nonspecific reactions may occur. One pattern of apparent nonspecific reactivity is a panagglutinin with a negative direct antiglobulin test (DAT). The purpose of this study was to define the clinical characteristics of patients with these nonspecific reactions and their associated serologic findings. Twenty patients with panreactive SPRCA testing results were identified between November 2022 and May 2023. In addition to panagglutinins, these patients had (1) a negative polyethylene glycol (PEG) antibody detection test, (2) a negative PEG autocontrol, and (3) a negative DAT. The strength of SPRCA panreactivity and the results of eluate testing (by tube and SPRCA) were studied. Clinical characteristics of patients included age, sex, and primary diagnosis. Each patient was also assessed for evidence of hemolysis. Fourteen female and six male patients were evaluated (average age 44 years). Primary diagnoses included pregnancy (<i>n</i> = 10), acute bleeding (<i>n</i> = 4), orthopedic (<i>n</i> = 3), and other (<i>n</i> = 3). There was no clinical or laboratory evidence of hemolysis. The predominant strength of SPRCA panreactivity was evenly distributed across reaction grades (1+ to 3+). Fifty-five percent of the eluates tested in PEG showed panreactivity, consistent with warm-reactive autoantibodies, while 85 percent of eluates tested by SPRCA were panreactive. Six discrepant cases, in which PEG eluate testing was negative and solid-phase eluate testing showed panreactivity, were associated with weak solid-phase plasma panreactivity (1+). In addition, the reactivity strengths of the eluates tested by SPRCA were invariably more strongly reactive than those eluates tested in PEG. Panagglutination is a distinct SPRCA-only plasma reactivity pattern. Despite a negative PEG tube and DAT, most panagglutinins are warm-reactive autoantibodies. Fortunately, these \"interfering\" panagglutinins do not appear to be clinically significant and are easily managed by an alternative testing method such as PEG.</p>","PeriodicalId":13357,"journal":{"name":"Immunohematology","volume":"39 4","pages":"151-154"},"PeriodicalIF":0.0,"publicationDate":"2023-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139097753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
ImmunohematologyPub Date : 2023-10-16eCollection Date: 2023-09-01DOI: 10.2478/immunohematology-2023-017
G M Meny, M A Keller, C Flickinger
{"title":"Update on programs for achieving Specialist in Blood Banking certification in the United States: 2023.","authors":"G M Meny, M A Keller, C Flickinger","doi":"10.2478/immunohematology-2023-017","DOIUrl":"10.2478/immunohematology-2023-017","url":null,"abstract":"<p><p>A person who has achieved the Specialist in Blood Banking (SBB) certification is a medical laboratory scientist who receives advanced training in blood banking and transfusion medicine and has passed an examination given by the American Society for Clinical Pathology. There are several pathways or \"eligibility routes\" to qualify for the examination to obtain SBB certification, with the most common route involving enrollment in a Commission on Accreditation of Allied Health Education Programs-accredited SBB program. The goal of this study was to compile information about the current accredited SBB programs in the United States and SBB exam statistics for purposes of assessing changes in the programs and detecting trends in SBB exam takers and pass rates. SBB program coordinators were surveyed about qualitative and quantitative aspects of their programs. Current data, changes over time, and nationally available data were tabulated for comparison. This information may be helpful for all medical laboratory scientists interested in considering further studies and certification in blood banking and transfusion medicine.</p>","PeriodicalId":13357,"journal":{"name":"Immunohematology","volume":"39 3","pages":"101-133"},"PeriodicalIF":0.0,"publicationDate":"2023-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41235000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
ImmunohematologyPub Date : 2023-10-16eCollection Date: 2023-09-01DOI: 10.2478/immunohematology-2023-019
Susan T Johnson
{"title":"Proud to be a medical laboratory scientist.","authors":"Susan T Johnson","doi":"10.2478/immunohematology-2023-019","DOIUrl":"10.2478/immunohematology-2023-019","url":null,"abstract":"","PeriodicalId":13357,"journal":{"name":"Immunohematology","volume":"39 3","pages":"136-137"},"PeriodicalIF":0.0,"publicationDate":"2023-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41234997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
ImmunohematologyPub Date : 2023-10-16eCollection Date: 2023-09-01DOI: 10.2478/immunohematology-2023-020
Peter D Issitt
{"title":"Peter D. Issitt (1933-2023).","authors":"Peter D Issitt","doi":"10.2478/immunohematology-2023-020","DOIUrl":"10.2478/immunohematology-2023-020","url":null,"abstract":"","PeriodicalId":13357,"journal":{"name":"Immunohematology","volume":"39 3","pages":"138"},"PeriodicalIF":0.0,"publicationDate":"2023-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41234996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
ImmunohematologyPub Date : 2023-10-16eCollection Date: 2023-09-01DOI: 10.2478/immunohematology-2023-016
T C S Silva, M R Dezan, B R Cruz, S S M Costa, C L Dinardo, J O Bordin
{"title":"Standardization of a multiplex assay to identify weak D types in a mixed-race Brazilian population.","authors":"T C S Silva, M R Dezan, B R Cruz, S S M Costa, C L Dinardo, J O Bordin","doi":"10.2478/immunohematology-2023-016","DOIUrl":"10.2478/immunohematology-2023-016","url":null,"abstract":"<p><p><i>RH</i> allele variability is caused by several types of variants, resulting in altered RhD and RhCE phenotypes. Most of the weak D phenotypes in European-derived populations are weak D types 1, 2, or 3, which are not involved in alloimmunization episodes. However, the Brazilian population is racially diverse, and the accuracy of molecular and serologic tests developed in recent years has allowed for the identification of other <i>RH</i> variants, that are common in the Brazilian population, such as weak D type 38 or weak partial 11, the latter involved in alloimmunization cases. Furthermore, patients with these two weak D variants must be transfused with D- red blood cell units, as do patients with weak D type 4 or DAR, which are also common D variants in Brazil. Weak D type 38 and weak partial 11 can be serologically misclassified as weak D types 1, 2, or 3 in patients, based on European experience, or as D- in donors. Additionally, pregnant women may unnecessarily be identified as requiring Rh immune globulin. RhCE phenotypes are reliable indicators of RhD variants. For individuals with the Dce phenotype, the preferred approach is to specifically search for <i>RHD*DAR</i>. However, when encountering DCe or DcE phenotypes, we currently lack a developed method that assists us in rapidly identifying and determining the appropriate course of action for the patient or pregnant woman. Two multiplex assays were proposed: one for the identification of <i>RHD*weak partial 11, RHD*weak D type 38</i>, and <i>RHD*weak D type 3</i> and another for <i>RHD*weak D type 2</i> and <i>RHD*weak D type 5</i>. The multiplex assays were considered valid if the obtained results were equivalent to those obtained from sequencing. Expected results were obtained for all tested samples. The proposed multiplex allele-specific polymerase chain reaction assays can be used in the molecular investigation of women of childbearing age, patients, and blood donors presenting a weak D phenotype with DCe or DcE haplotypes in a mixed-race population, such as Brazil.</p>","PeriodicalId":13357,"journal":{"name":"Immunohematology","volume":"39 3","pages":"93-100"},"PeriodicalIF":0.0,"publicationDate":"2023-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41234998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}