Antibody Identification Using Both Automated Solid-phase Red Cell Adherence Assay and Tube Polyethylene Glycol Antiglobulin Method: A Comparative Study.

BACKGROUND

Accurate antibody identification is crucial for safe transfusion practices. Conventionally, tube antiglobulin methods using polyethylene glycol (PEG-AHG) are considered the gold standard. However, recent advances such as automated solid-phase red cell adherence (SPRCA) assays have improved standardization and reduced subjectivity.

OBJECTIVE

The objective of this study was to compare the performance, efficiency, and concordance of antibody identification using the automated SPRCA method (Immucor NEO platform) with the conventional tube PEG-AHG method in a tertiary care transfusion laboratory.

MATERIALS AND

METHODS

This prospective, observational study included 1000 patient samples received for antibody screening and identification over a period of 12 months. Each sample was tested simultaneously using the Immucor NEO automated SPRCA system and the conventional tube PEG-AHG method. The parameters compared included detection rate, specificity, sensitivity, turnaround time (TAT), and concordance with clinical history.

RESULTS

Out of 1000 samples, antibodies were detected in 108 (10.8%) by at least one method. The SPRCA method detected 106 antibodies (10.6%), whereas the PEG-AHG method detected 98 (9.8%). Complete concordance between both the methods was observed in 940 (94%) samples, while 60 (6%) samples showed discordant results. SPRCA demonstrated higher sensitivity (98.1%) and reduced manual error with an average TAT of 18 min per batch, compared to 35 min for the PEG-AHG method. Commonly identified antibodies included anti-D, anti-E, anti-K, and combinations thereof.

CONCLUSION

The automated SPRCA method using the Immucor NEO platform offers superior sensitivity, reproducibility, and efficiency for antibody identification compared to the conventional tube PEG-AHG method. Integration of automation into transfusion laboratories enhances workflow and patient safety by minimizing subjectivity and variability.