BACKGROUND: The use of automated systems for pre-transfusion tests is increasing in an attempt to reduce workload and the impact of human errors in blood banks. We evaluated the clinical performance of the automated blood bank systems IH-500 (Bio-Rad Laboratories, Switzerland) and VISION Max (Ortho-Clinical Diagnostics, USA) for ABO-RhD blood typing and unexpected antibody screening. METHODS: ABO-RhD blood typing was performed for 410 samples, and antibody screening was performed for 332 samples, including 15 antibody-positive samples. The results obtained from the two automated instruments were compared with those obtained using manual methods for ABO-RhD blood typing and a semiautomated method (DiaMed-ID system) for antibody screening. Additionally, both instruments were evaluated in terms of concordance rates, sensitivity, and carryover. RESULTS: The concordance rate of the ABO-RhD blood typing results between the manual methods and the two automated instruments was 100%. For antibody screening tests, the concordance rates between the semiautomated method (DiaMed-ID system) and the automated methods were 100% and 99.7% for the IH-500 and VISION Max instruments, respectively. The sole discrepant result was obtained for a sample identified as antibody-positive only on the VISION Max; the antibody was identified as anti-Le(a). The overall sensitivity of the two automated instruments was the same as or higher than that of the semiautomated method. Carryover was not observed in antibody screening. CONCLUSIONS: The IH-500 and VISION Max instruments showed reliable results for ABO-RhD blood typing and unexpected antibody screening, and can be used clinically, with confidence, for pre-transfusion tests in the blood bank.
Automation ; Blood Banks* ; Blood Grouping and Crossmatching* ; Humans ; Mass Screening* ; Methods

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

This study was aimed to investigate one case with rare type B(A) in ABO blood group by using serological and molecular biological methods, and analyze the cause of inconsistency resulting from multiple detections. The serological method was used to identify the serum type of ABO blood group, at the same time the PCR sequencing method was used to detect the genotypes. The results indicated that the group typing and reverse typing for the blood donor were inconsistent, the group typing was AB, the reverse typing was B. The ABO genotype was B(A) 04 /001. This genotype was involved in nt640A > G point mutation which caused valine replacing methionine at 214. It is concluded that the sample inconsistent between the group typing and reverse typing could be typed by molecular biological method, and the molecular basis of weak expression of ABO blood group is elucidated too.
ABO Blood-Group System ; genetics ; Blood Donors ; Blood Grouping and Crossmatching ; methods ; Genotype ; Humans ; Serologic Tests

BACKGROUND: According to increased availability and awareness of automated blood bank analyzer with its speed and efficiency, use of automated analyzer in hospital blood bank has been increasing rapidly. We compared the ABO blood group typing results between automated analyzer IH-500 and manual method in healthy adults and patients with ABO discrepancies to provide useful information on interpretation of blood grouping results by automated analyzer. METHODS: Among healthy adults who underwent medical examinations, 400 samples (each 100 samples of A, B, O and AB type) were selected and evaluated the results and grades of blood grouping by automated and manual methods. Also, 50 samples showing ABO discrepancies among patients requested for pretransfusion test were selected and compared between two methods. As for samples with ABO discrepancies, further tests such as microscopic examination, reactivity with anti-A1 or ABO genotyping along with medical record review were performed. RESULTS: Agglutination results and grades in healthy adults were consistent between two methods. Meanwhile, 30 (60%) of ABO discrepant samples were related to rouleaux formation and their frequencies and agglutination grades were higher in automated method (Wilcoxon signed rank test, P=0.001). Results of discrepant samples caused by unexpected antibody or ABO subgroup showed no differences between two methods. CONCLUSION: IH-500 automated analyzer was considered useful for mass examination of healthy individuals. Meanwhile, considering the fact that ABO discrepancies by rouleaux formation were more frequent and stronger in automated method, it is recommended to retest their results by manual methods along with medical record review.
Adult ; Agglutination ; Blood Banks* ; Blood Grouping and Crossmatching ; Humans ; Medical Records ; Methods*

The aim of this study was to investigate the effect of alanine solution as α-N-acetylgalactosaminidase enzyme reaction buffer on the enzymatic activity of A antigen. The binding ability of α-N-acetylgalactosaminidase with RBC in different reaction buffer such as alanine solution, glycine solution, normal saline (0.9% NaCl), PBS, PCS was detected by Western blot. The results showed that the efficiency of A to O conversion in alanine solution was similar to that in glycine solution, and Western blot confirmed that most of enzymes blinded with RBC in glycine or alanine solution, but few enzymes blinded with RBC in PBS, PCS or normal saline. The evidences indicated that binding of enzyme with RBC was a key element for A to O blood group conversion, while the binding ability of α-N-acetylgalactosaminidase with RBC in alanine or glycine solution was similar. It is concluded that alanine solution can be used as enzyme reaction buffer in A to O blood group conversion. In this buffer, the α-N-acetylgalactosaminidase is closely blinded with RBC and α-N-acetylgalactosaminidase plays efficient enzymatic activity of A antigen.
ABO Blood-Group System ; immunology ; Alanine ; Blood Grouping and Crossmatching ; methods ; Humans ; Solutions ; alpha-N-Acetylgalactosaminidase ; immunology

The ABO blood group system is the most important blood group system in clinical transfusion. Serological technology is a routine method for the identification of ABO blood groups, however, which have some limitations in the identification of complicated ABO samples with weakened antigens or antibodies, abnormal plasma proteins, polyagglutination, or cold agglutinin, etc. With the development of molecular biology technology, ABO blood group gene was cloned, and ABO blood group genotyping technology based on DNA was established. The genotyping technologies with different throughputs such as PCR-SSP, Droplet-AS-PCR, PCR-RFLP, PCR-SBT, SNaPshot, MALDI-TOF MS and NGS have emerged. Genotyping has overcome the limitations of serology, and has become an indispensable method to solve difficult blood type, providing strong support for the correct identification of ABO blood group, and providing guarantee for precision blood transfusion. This review summarizes the progress and application of ABO blood group genotyping methods.
ABO Blood-Group System/genetics* ; Blood Grouping and Crossmatching ; Genotype ; Humans ; Polymerase Chain Reaction/methods* ; Technology

BACKGROUND: An automated immunohematology analyzer, DAYMATE M (DAY Medical, Switzerland), has been recently developed. The potential of this analyzer to improve test results has been evaluated. METHODS: A total of 300 blood samples from Seoul St. Mary's hospital and Incheon St. Mary's hospital were tested for ABO and RhD typing. In addition, 336 antibody screening test (AST) samples and 82 patients treated with hematopoietic stem cell transplantation (HSCT) were included. AST results by DAYMATE M were compared with those obtained by a manual method using DS-Screening II (Bio-Rad Laboratories, Switzerland) and red blood cells from Selectogen (Ortho-Clinical diagnostics Inc., USA). RESULTS: Of the 300 patients enrolled, 87, 73, 79, and 61 had type A, B, O, and AB blood, respectively. The concordance rate was 99.9% for cell typing and 97.0% for serum typing. One discordant case was classified as type B instead of AB, and six discordant serum-typing cases were type A, but classified as type AB. Among the 336 AST samples, the concordance rate was 93.2%. From 136 positive cases, six were discordant. Within the 82 HSCT-treated patients, the concordance rate for ABO blood typing was 92.2%. Among the six discordant cases, DAYMATE M typed four cases as donor type where the standard method typed them as the recipient blood type. CONCLUSIONS: The DAYMATE M automated immunohematology analyzer performs reliably for ABO and RhD typing, as well as for ASTs and on samples from patients treated with HSCT.
Blood Grouping and Crossmatching ; Erythrocytes ; Hematopoietic Stem Cell Transplantation ; Humans ; Incheon ; Mass Screening ; Methods ; Seoul ; Tissue Donors

This study was aimed to establish the technique for preparation and storage of internal quality control pro-ducts by using existing blood sample resources of blood transfusion compatibility testing laboratory. 24 healthy blood donors with group A and RhD-positive were randomly selected, and 4 ml venous blood from these donors were collected, respectively. Based on the use of anticoagulant type, whether to add red blood cell preservation solution and the samples stored at room temperature for 1 or 2 hours daily, 24 specimens were randomly divided into 8 groups by using factorial design methodology. All samples in tube with cap were stored at 4 degrees C, and placed at room temperature for 1 or 2 hours daily. ABO, RhD blood group (recorded on the agglutination strength of the forward and reverse typing), IgM anti-B antibody titer, and free hemoglobin concentration in the supernatant for all samples were detected at 0, 7, 14, 21, 28, 35 days of products preservation. The results indicated that the red blood cell damage from the group used anticoagulants ACD-B and added the MAP red blood cell preservation solution and placed at room temperature 1 hour daily (recorded as A2B2C1 group) was kept minimal, and FHb concentration and FHb increments at each time point were the lowest (p < 0.01), the FHb concentration on 35th day was only (24.5 +/- 84.5) mg/L. There was no significant change of A antigen, D antigen and IgM anti-B antibody response activity and stability in A2B2C1 group during storage for 35 days (p > 0.05). In conclusion, blood transfusion compatibility testing laboratory can use A2B2C1 program established by this study to prepare relatively stable modified whole blood internal quality control products in the existing conditions, which can be effectively preserved and meet the requirements of internal quality control for blood transfusion compatibility testing.
ABO Blood-Group System ; Automation ; Blood Donors ; Blood Grouping and Crossmatching ; Blood Preservation ; methods ; Blood Transfusion ; Humans ; Quality Control

To study the detection of weak D and Del from samples initially screened RhD(-), RhD phenotype was initially screened by routine serological test, out of which weak D phenotype was detected by indirect antiglobulin test (IAT) and Del phenotype was detected by chloroform-trichloroethylene absorption-elution test. The results showed that 56 samples were RhD(-) confirmed by routine serology test, which were screened out of 26 200 donors, among them 5 samples were typed as weak D by IAT and 9 cases samples were typed as Del by absorption-elution test. In conclusion, the samples which typed as RhD(-) by routine serological test must be identified by IAT and chloroform-trchloroethylene absorption test is order to detect weak D and Del phenotype. It is important for clinical transfusion safely.
Blood Donors ; Blood Grouping and Crossmatching ; methods ; standards ; Epitopes ; immunology ; Erythrocytes ; immunology ; Humans ; Rh-Hr Blood-Group System ; blood ; immunology

The purpose of this study was to determine whether the fully automated ORTHO AutoVue Innova system, which based on the microcolumn glass sphere technology, is accurate enough to meet immunohematology testing needs at blood banks. 16 IgM anti-C, anti-c, anti-D, anti-E and anti-e dilution series were tested respectively, with corresponding antigen positive red blood cell solutions, by ORTHO AutoVue Innova system and saline medium test. 16 IgG anti-D dilution series were tested respectively with RhD positive red blood cell solutions by ORTHO AutoVue Innova system, polybrene test and antiglobulin test. The accuracies of microcolumn glass sphere technology were analysed, by comparing to the reference assays. The results showed that the sensitivities of the ORTHO AutoVue Innova tests were 1:69.8, 1:33.4, 1:1448.1, 1:139.6 and 1:32.0 for IgM anti-C, anti-c, anti-D, anti-E and anti-e respectively; the corresponding value of saline medium tests were 1:16.7, 1:16.6, 1:430.5, 1:34.9 and 1:9.9. There were statistically significant differences between the groups of each tests (t values were 14.38, 5.48, 10.25, 12.65 and 9.59 for IgM anti-C, anti-c, anti-D, anti-E and anti-e respectively, p < 0.05). For IgG anti-D, the sensitivities of the ORTHO AutoVue Innova test, polybrene test and antiglobulin test were 1:980.6, 1:181.0 and 1:304.4 respectively. There was statistically significant difference among the 3 groups (F = 51.15, p < 0.01). It is concluded the use of ORTHO AutoVue Innova system for blood group compatibility test can obtain more accurate results than traditional tube tests, it is reliable and safe for routine tests performed in immunohematology laboratories.
Blood Grouping and Crossmatching ; methods ; Coombs Test ; methods ; Humans ; Isoantibodies ; blood ; Materials Testing ; Rho(D) Immune Globulin ; Sensitivity and Specificity