Comparison of automated solid phase versus manual saline indirect antiglobulin test methodology for non‐ABO antibody titration: Implications for perinatal antibody monitoring

Background Accurate antibody titration is crucial in prenatal evaluations to identify patients who need clinical monitoring for hemolytic disease of the fetus and newborn (HDFN) causing fetal anemia. This study compares the established gold standard method of manual tube saline indirect antiglobulin...

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Veröffentlicht in:Transfusion (Philadelphia, Pa.) Pa.), 2023-12, Vol.63 (12), p.2289-2296
Hauptverfasser: Niu, Shuang, Vetsch, Megan, Beaudin, Lynnette, Bodnar, Melanie, Clarke, Gwen
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container_issue 12
container_start_page 2289
container_title Transfusion (Philadelphia, Pa.)
container_volume 63
creator Niu, Shuang
Vetsch, Megan
Beaudin, Lynnette
Bodnar, Melanie
Clarke, Gwen
description Background Accurate antibody titration is crucial in prenatal evaluations to identify patients who need clinical monitoring for hemolytic disease of the fetus and newborn (HDFN) causing fetal anemia. This study compares the established gold standard method of manual tube saline indirect antiglobulin testing (SIAT) with the newer automated solid phase (ASP) method of antibody titration and aims to establish the critical titer threshold for ASP that corresponds to the previously established SIAT critical threshold of ≥16 used in our laboratory. Study Design and Methods One hundred fifty‐seven prenatal and donor plasma samples with known antibodies were tested using both SIAT and ASP methodologies and results were compared. Results The study found that ASP titers were, on average, 1.33 dilutions higher than SIAT titers. The critical titer cutoff for ASP was determined to be ≥32, which is one tube higher than the SIAT cutoff of ≥16. Discussion The ASP method for antibody titration offers greater reproducibility and efficiency compared with manual SIAT titration. This study suggests that a titer cutoff of ≥32 is appropriate for most clinically significant antibodies using ASP. However, further research is needed to determine the comparability of ASP with SIAT in samples with multiple antibodies, anti‐M antibodies, and other less common antibodies. Validation of the ASP titer cutoff against HDFN clinical outcomes is required before implementing this test for routine use in perinatal antibody titration.
doi_str_mv 10.1111/trf.17571
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This study compares the established gold standard method of manual tube saline indirect antiglobulin testing (SIAT) with the newer automated solid phase (ASP) method of antibody titration and aims to establish the critical titer threshold for ASP that corresponds to the previously established SIAT critical threshold of ≥16 used in our laboratory. Study Design and Methods One hundred fifty‐seven prenatal and donor plasma samples with known antibodies were tested using both SIAT and ASP methodologies and results were compared. Results The study found that ASP titers were, on average, 1.33 dilutions higher than SIAT titers. The critical titer cutoff for ASP was determined to be ≥32, which is one tube higher than the SIAT cutoff of ≥16. Discussion The ASP method for antibody titration offers greater reproducibility and efficiency compared with manual SIAT titration. This study suggests that a titer cutoff of ≥32 is appropriate for most clinically significant antibodies using ASP. However, further research is needed to determine the comparability of ASP with SIAT in samples with multiple antibodies, anti‐M antibodies, and other less common antibodies. Validation of the ASP titer cutoff against HDFN clinical outcomes is required before implementing this test for routine use in perinatal antibody titration.</description><identifier>ISSN: 0041-1132</identifier><identifier>EISSN: 1537-2995</identifier><identifier>DOI: 10.1111/trf.17571</identifier><identifier>PMID: 37921080</identifier><language>eng</language><publisher>Hoboken, USA: John Wiley &amp; Sons, Inc</publisher><subject>ABO system ; alloimmunization ; Anemia ; Antibodies ; automated solid phase ; Automation ; conventional tube testing ; Coombs Test ; Erythroblastosis, Fetal - diagnosis ; Female ; Fetuses ; Hemolytic disease ; hemolytic disease of the fetus and newborn (HDFN) ; Humans ; Immunologic Tests ; Infant, Newborn ; Monitoring ; perinatal antibody titration ; Pregnancy ; Reproducibility of Results ; Solid phases ; Telemedicine ; Titration</subject><ispartof>Transfusion (Philadelphia, Pa.), 2023-12, Vol.63 (12), p.2289-2296</ispartof><rights>2023 The Authors. published by Wiley Periodicals LLC on behalf of AABB.</rights><rights>2023 The Authors. 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This study compares the established gold standard method of manual tube saline indirect antiglobulin testing (SIAT) with the newer automated solid phase (ASP) method of antibody titration and aims to establish the critical titer threshold for ASP that corresponds to the previously established SIAT critical threshold of ≥16 used in our laboratory. Study Design and Methods One hundred fifty‐seven prenatal and donor plasma samples with known antibodies were tested using both SIAT and ASP methodologies and results were compared. Results The study found that ASP titers were, on average, 1.33 dilutions higher than SIAT titers. The critical titer cutoff for ASP was determined to be ≥32, which is one tube higher than the SIAT cutoff of ≥16. Discussion The ASP method for antibody titration offers greater reproducibility and efficiency compared with manual SIAT titration. This study suggests that a titer cutoff of ≥32 is appropriate for most clinically significant antibodies using ASP. 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subjects ABO system
alloimmunization
Anemia
Antibodies
automated solid phase
Automation
conventional tube testing
Coombs Test
Erythroblastosis, Fetal - diagnosis
Female
Fetuses
Hemolytic disease
hemolytic disease of the fetus and newborn (HDFN)
Humans
Immunologic Tests
Infant, Newborn
Monitoring
perinatal antibody titration
Pregnancy
Reproducibility of Results
Solid phases
Telemedicine
Titration
title Comparison of automated solid phase versus manual saline indirect antiglobulin test methodology for non‐ABO antibody titration: Implications for perinatal antibody monitoring
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