Ann Lab Med.  2025 May;45(3):334-338. 10.3343/alm.2024.0521.

ABO Antibody Titer Testing Harmonization in Korea: A 5-Year Analysis of External Quality Control Data

• Kim HJ
• Chung Y
• Hwang SH
• Oh HB
• Kim H
• Ko DH

• KMID: 2567975
• DOI: http://doi.org/10.3343/alm.2024.0521

Abstract

Current ABO titration methods lack standardization and harmonization. We analyzed the consistency of ABO antibody titer testing among Korean laboratories and discussed future directions for standardization by analyzing external quality control data collected by the Korean Association of External Quality Assessment Service over 5 yrs (2019–2023). The analysis included the number of participating institutions and methods, as well as the proportion of acceptable results. To compare column agglutination technology (CAT) and tube methods, we created a normalized variable: ([log ₂ titer of laboratory test result]–[mean of log 2 titer for the peer group]). The number of participating institutions and methods increased over time. The use of CAT methods expanded, whereas that of tube methods declined. The proportion of acceptable results ranged from 84.0% to 100%, with no significant differences between CAT and tube methods. An F-test revealed no significant variance differences among institutions using these methods. Tube methods demonstrated lower variance in anti-human globulin testing, and room temperature tube methods exhibited lower variance than that of CAT methods. Domestic laboratories demonstrated highquality performance in ABO antibody titer testing, with no significant differences in acceptable result rates or variance across methods. Continuous efforts toward standardization remain essential.

Keyword

ABO antibody titer testing; ABO titration; External Quality Control; Standardization Received: October 2, 2024 Revision received: December 26, 2024 Accepted: March 1, 2025 Published online: April 2, 2025 Corresponding author: Hyungsuk Kim, M.D., Ph.D. Department of Lab

Figure

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  Fig. 1 Numbers of acceptable and unacceptable results for the CAT (1,080/1,120, 96.4%) and tube (1,422/1,492, 95.3%) methods from 2019 to 2023 (P=0.1584). Abbreviation: CAT, column agglutination technology.

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  Fig. 2 Results of F-test. (A) Distribution of F-test results comparing the CAT and tube methods, revealing no significant difference in variance in results between the two methods (P=0.507). (B) F-test results comparing the CAT and tube methods for AHG and RT phases. The tube method shows significantly lower variance in both phases (P=0.011 for AHG, P=0.001 for RT). The box denotes the 1st–3rd quartiles, the horizontal line inside the box represents the median. Horizontal lines are drawn at the upper and lower adjacent values. Red circles indicate values outside the inner fences, and red squares indicate values outside the outer fences. Abbreviations: CAT, column agglutination technology; AHG, anti-human globulin; RT, room temperature.

Reference

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