Ann Lab Med.  2017 Mar;37(2):117-123. 10.3343/alm.2017.37.2.117.

Comparative Analysis of Clinical Samples Showing Weak Serum Reaction on AutoVue System Causing ABO Blood Typing Discrepancies

• Jo SY
• Lee JM
• Kim HL
• Sin KH
• Lee HJ
• Chang CL
• Kim HH

• KMID: 2373628
• DOI: http://doi.org/10.3343/alm.2017.37.2.117

Abstract

BACKGROUND
ABO blood typing in pre-transfusion testing is a major component of the high workload in blood banks that therefore requires automation. We often experienced discrepant results from an automated system, especially weak serum reactions. We evaluated the discrepant results by the reference manual method to confirm ABO blood typing.
METHODS
In total, 13,113 blood samples were tested with the AutoVue system; all samples were run in parallel with the reference manual method according to the laboratory protocol.
RESULTS
The AutoVue system confirmed ABO blood typing of 12,816 samples (97.7%), and these results were concordant with those of the manual method. The remaining 297 samples (2.3%) showed discrepant results in the AutoVue system and were confirmed by the manual method. The discrepant results involved weak serum reactions (<2+ reaction grade), extra serum reactions, samples from patients who had received stem cell transplants, ABO subgroups, and specific system error messages. Among the 98 samples showing ≤1+ reaction grade in the AutoVue system, 70 samples (71.4%) showed a normal serum reaction (≥2+ reaction grade) with the manual method, and 28 samples (28.6%) showed weak serum reaction in both methods.
CONCLUSIONS
ABO blood tying of 97.7% samples could be confirmed by the AutoVue system and a small proportion (2.3%) needed to be re-evaluated by the manual method. Samples with a 2+ reaction grade in serum typing do not need to be evaluated manually, while those with ≤1+ reaction grade do.

Keyword

ABO typing; Automated system; AutoVue system; Manual method; Discrepancy

MeSH Terms

ABO Blood-Group System/*blood
Automation
Blood Banks
Blood Grouping and Crossmatching/instrumentation/*methods
Humans
ABO Blood-Group System

Reference

1. Davies A, Staves J, Kay J, Casbard A, Murphy MF. End-to-end electronic control of the hospital transfusion process to increase the safety of blood transfusion: strengths and weaknesses. Transfusion. 2006; 46:352–364. PMID: 16533276.

2. Sandler SG, Langeberg A, Avery N, Mintz PD. A fully automated blood typing system for hospital transfusion services. ABS2000 Study Group. Transfusion. 2000; 40:201–207. PMID: 10686004.

3. Chang C, Brown M, Davies L, Pointon L, Brown R, Barker D. Evaluation of Erytra® fully automated analyser for routine use in transfusion laboratory. Transfus Med. 2014; 24:33–38. PMID: 24188135.

4. Garratty G. Advances in red blood cell immunology 1960 to 2009. Transfusion. 2010; 50:526–535. PMID: 20609200.

5. Butch SH. Automation in the transfusion service. Immunohematology. 2008; 24:86–92. PMID: 19845075.

6. Cheng YW, Wilkinson JM. An experience of the introduction of a blood bank automation system (Ortho AutoVue Innova) in a regional acute hospital. Transfus Apher Sci. 2015; 53:58–63. PMID: 25863409.

7. Bajpai M, Kaur R, Gupta E. Automation in immunohematology. Asian J Transfus Sci. 2012; 6:140–144. PMID: 22988378.

8. AuBuchon JP. Emily Cooley Memorial Award. Managing change to improve transfusion safety. Transfusion. 2004; 44:1377–1383. PMID: 15318865.

9. Dada A, Beck D, Schmitz G. Automation and Data Processing in Blood Banking Using the Ortho AutoVue Innova System. Transfus Med Hemother. 2007; 34:341–346.

10. Shin SY, Kwon KC, Koo SH, Park JW, Ko CS, Song JH, Sung JY. Evaluation of Two Automated Instruments for Pre-transfusion Testing: AutoVue Innova and Techno TwinStation. Korean J Lab Med. 2008; 28:214–220. PMID: 18594174.

11. An TK, Song YK, Seo HS, Kim KL, Kim JA, Ko CH, Lee DH, Kong SY. Evaluation of Automated Blood Bank Systems AutoVue Innova and QWALYS-3 for ABO-RhD Grouping and Antibody Screening. Korean J Blood Transfus. 2012; 23:204–209.

12. Kim SH, Nam DH, Yang JH, Yoon SY, Kim YK, Lee KN, Lim CS. Evaluation of the Automatic Blood Bank Instrument AutoVue Innova for Antibody Screening. Korean J Blood Transfus. 2008; 19:140–145.

13. British Committee for Standards in Haemotology. Milkins C, Berryman J, Cantwell C, Elliot C, Hassa R, et al. Guidelines for pre-transfusion compatibility procedures in blood transfusion laboratories. Transfus Med. 2013; 23:3–35. PMID: 23216974.

14. Taylor J, Hyare J, Stelfox P, Williams M, Lees R, Maley M. Multi-centre evaluation of pre-transfusional routine tests using 8-column format gel card (DG Gel®). Transfus Med. 2011; 90–98. PMID: 21118316.

15. Cooling L. ABO, H, and Lewis Blood Groups and Structurally Related Antigens. In : Fung MK, Grossman BJ, editors. Technical manual. 18th ed. Bethesda: American Association of Blood Banks;2014. p. 291–315.

16. Cho D, Lee JS, Park JY, Jeon MJ, Song JW, Kim SH, et al. Resolution of ABO discrepancies by ABO genotyping. Korean J Lab Med. 2006; 26:107–113. PMID: 18156710.

17. Bhagwat SN, Sharma JH, Jose J, Modi CJ. Comparison between conventional and automated techniques for blood grouping and crossmatching: experience from a tertiary care centre. J Lab Physicians. 2015; 7:96–102. PMID: 26417159.

18. Storry JR. The ABO blood group system revisited: a review and update. Immunohematology. 2009; 25:48–59. PMID: 19927620.