An exploration of the advantages of automated titration testing: low inter-instrument variability and equivalent accuracy for ABO and non-ABO antibody titres relative to tube testing

Brian D. Adkins, Shanna A. Arnold Egloff, Kayla Fahey-Ahrndt, Andrea L. Kjell, Claudia S. Cohn, Pampee P. Young

Research output: Contribution to journalArticle

Abstract

Background and objectives: Obtaining IgM and IgG titres is important in numerous clinical situations, including solid-organ transplant, obstetrics, and for testing of out-of-group plasma-containing components. Tube method is the most prevalent testing modality, though it is both labour-intensive and known for intra- and inter-laboratory variability. The utility of automated gel testing as a method to improve both inter- and intra-laboratory reproducibility is unknown. Materials and methods: Two academic centres participated in a study evaluating automated gel titreing. Group O plasma samples were used to measure titres of antibodies against ABO (IgM) with buffered gel cards and 4 minor and minor red-blood-cell antigens (IgG) anti-IgG gel cards. Multiple ORTHO VISION automated analyzers were used to assess inter-instrument variation. A subset of ABO (IgM) samples were compared between laboratories to evaluate inter-laboratory variability. Multiple samples were titred by tube and by automated gel technology to determine similarity of results. Results: Testing demonstrated no significant difference between analysers or between sites when performing automated titrations (P ≥ 0·99). Non-ABO IgG titres were evaluated and demonstrated little inter-instrument variability. The IgM anti-A and -B titres obtained by automated gel testing were neither consistently higher nor lower than tube titres. Greater than 90% of titre values were within one dilution. Conclusion: Based on this study, our data suggest that titreing by automated gel testing is both highly reproducible (IgM and IgG) and does not differ significantly from manual tube testing results of direct agglutination (IgM).

Original languageEnglish (US)
Pages (from-to)314-322
Number of pages9
JournalVox Sanguinis
Volume115
Issue number4
DOIs
StatePublished - May 1 2020

Keywords

  • RBC antigens and antibodies
  • immunohaematology
  • serological testing
  • transfusion medicine (in general)
  • transplantation

PubMed: MeSH publication types

  • Journal Article

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