Evaluation of the analytical performance of four different manufacturer’s reagent red blood cells in antibody detection and identification

Abstract

Abstract Objective The detection/identification of clinically significant antibodies to red cell antigens form the foundation for safe transfusion practices. This study aimed to evaluate the diagnostic performance of commercially available 0.8% reagent red blood cells (RRBCs) in Australia. 166 patient-derived plasma samples with a positive indirect antiglobulin test (IAT) were tested using column agglutination technology (CAT) with Immulab, Bio-Rad, Grifols and QuidelOrtho screening and identification RRBCs with the respective manufacturer’s proprietary CAT system. Results False-negative antibody screening and identification results were obtained with Bio-Rad (3/61), Grifols (14/68) and Quidel-Ortho (3/59) RRBCs when tested with the respective manufacturer’s proprietary CAT system. Zero false-negative results were observed with Immulab RRBCs when tested with samples across all platforms. The sensitivity of the RRBCs used in this study were calculated to be 95.83% (95%CI 88.30-99.13%) for Bio-Rad RRBCs, 82.50% (95%CI 72.38–90.09%) for Grifols RRBCs and 95.65% (95%CI 87.82–99.09%) for QuidelOrtho RRBCs. The sensitivity of Immulab RRBCs were stratified based on performance in the 3 CAT platforms: Bio-Rad CAT (100%, 95%CI 95.01–100%), Grifols CAT (100%, 95%CI 95.49–100%) and QuidelOrtho CAT (100%, 95%CI 94.79–100%). Conclusions RRBCs used in antibody detection and identification vary in diagnostic performance and should therefore be carefully considered before being implemented in routine patient testing.

Keywords

• Reagent red blood cells
• Antibody detection
• Antibody identification
• Analytical performance
• Pre-transfusion testing
• Blood transfusion