Which methods are used to perform antibody screening tests?

Updated: Jun 24, 2019
  • Author: Ashok Tholpady, MD, MSc; Chief Editor: Jun Teruya, MD, DSc, FCAP  more...
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Answer

Answer

Antibody screening consists of testing the recipient's plasma against the RBCs of 2 or 3 reagent screening cells that are licensed by the Food and Drug Administration (FDA). The screening cells must be type O with certain profiles for the following antigens: D, C, E, c, e, K, k, Fya, Fyb, Jka, Jkb, M, N, S, s, P1, Lea, and Leb.

The column (gel) agglutination method has gained widespread acceptance in clinical laboratories. [3] Instead of a test tube, the reactions are carried out in microtubes, which contain a dextran-acrylamide gel.

Advantages of the gel test include easy readability, stable results, no cell-washing step, and the ability to review results at a later time for quality control. [4, 5, 6] Furthermore, an increased number of overall antibodies and clinically significant antibodies can be detected relative to the tube method. [4] A study by Judd et al found the gel tube to have the same sensitivity in detecting clinically significant antibodies as the LISS tube method but a higher specificity. [7] A study by Bhangale et al concluded the gel method for anti A/B titer estimation in an ABO incompatible kidney transplant is more sensitive than tube titration. [8]

Another commonly used method is the SPRCA. This test utilizes microplate wells coated with the stroma of reagent RBCs of known phenotype.


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