Korean J Blood Transfus.  2024 Aug;35(2):106-112. 10.17945/kjbt.2024.35.2.106.

Contingency Plan for Anti-D Reagent Shortages for RhD Testing: Validation of Using Diluted Anti-D Reagents

• Kim TS
• Jung Y
• Kim M
• Yoo J
• Kim SY
• Nam HJ
• Shin S

• KMID: 2558983
• DOI: http://doi.org/10.17945/kjbt.2024.35.2.106

Abstract

Background
In early 2024, there was an issue with the supply of the anti-D reagent for blood typing. This reduced the anti-D reagent in our laboratory below the minimum stock level. We validated the appropriateness of using diluted anti-D reagents as a contingency plan in the event of an anti-D reagent shortage.
Methods
A total of eight dilutions, ranging from 2X to 256X, were prepared by serial dilution of the low-protein monoclonal anti-D reagent. The original anti-D reagent and the eight anti-D dilutions were used to perform RhD typing by the tube and plate methods. To further evaluate the reactivity and stability of the 8-fold diluted anti-D reagent, RhD typing was performed on internal quality control red blood cells and RhD-positive patient specimens for 30 days.
Results
The maximum dilution that gave the same results as the original anti-D reagent in both the tube and plate methods was 8X. The 8X anti-D dilution was tested against internal quality control red blood cells and patient specimens. It showed the same result as the original anti-D reagent, with reactivity remaining constant over 30 days.
Conclusion
We have confirmed the appropriateness of using a diluted low-protein monoclonal anti-D reagent for RhD typing. Therefore, we suggest that the diluted anti-D method can be considered for priority use in emergencies when the anti-D reagent is in short supply. Although 8X is suggested as an appropriate dilution factor in this study, this may vary depending on the type of product used in each laboratory and the laboratory conditions.

Keyword

Blood typing; Rh blood group system; Anti-D reagent