Testing the performance of fully automated blood cell washers in pretransfusion compatibility testing

The transfusion of donor red blood cells (RBCs) that are incompatible with the recipient's blood type can lead to immune-mediated hemolytic transfusion reaction, in which the recipient's immune system produces antibodies that destroy the donor cells. To avoid the harmful consequences of these hemolytic transfusion reactions, and to ensure that donor RBCs survive in the recipient, blood banks and hospital laboratories routinely perform pretransfusion compatibility testing.1 However, prior to performing these tests, the donor RBCs must be thoroughly washed with physiologic saline to remove unwanted components, such as residual plasma and cellular debris, which could otherwise impair the reliability and reproducibility of the test results. Blood cell washing techniques In both antibody screening tests and the DAT, the patient's RBCs must first be washed in physiologic saline to remove unwanted components such as plasma, plasma protein, microaggregates, cytokines, and unwanted antibodies, as these can interfere with the test procedure and produce inaccurate results. Not only is this a laborious and time-consuming process, but it has been suggested that manual washing poses a risk of contaminating the product due to human error, as well as the elution of low-affinity antibodies that interfere with the antigen-reagent/antibody reaction.5 Recently, more advanced, automated cell washing centrifuges are removing the need for these manual procedures.