Festphasentechnik versus Gelzentrifugation zum Nachweis erythrozytärer Antikörper - Eine prospektive Studie zum Vergleich zweier Antikörpersuchtests

ZIEL: Feststellung von Sensitivitäts- und Spezifitätsunterschieden zwischen Festphasentechnik und Gelzentrifugation im Nachweis von irregulären erythrozytären Antikörpern (AK). STUDIENDESIGN: 3052 Blutproben wurden in einer prospektiven Studie mit Gelzentrifugation {ID-System, (ID) 37 °C als Bromeli...

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Bibliographic Details
Main Author: Thiele, Sebastian
Contributors: Kretschmer, Volker (Univ-Prof. Dr. med.) (Thesis advisor)
Format: Doctoral Thesis
Published: Philipps-Universität Marburg 2003
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AIM: To define differences of specifity and sensitivity between a solid phase- and a gel centrifugation test for detection of irregular erythrocyte antibodies. STUDY DESIGN: 3052 blood samples were screened for erythrocyte antibodies (AB) by gel centrifugation {ID-System, (ID) 37 degrees C Bromelin and indirect antiglobulin test with LISS (IAT)} and a solid phase antiglobulin test {Capture-R Ready Screen (CR)} in a prospective study. Identical test cells were used as immobilized monolayer in CR and as 1%-suspension in ID. Additional, 42 sera with antibodies reacting in both tests were titered geometrically in both techniques. RESULTS: In 77 (2,52%) of all sera tested, irregular antibodies were detected. 62 (81%) of these positive sera were detected by both tests, 68 (88%) by CR and 71 (92%) by ID 6 (7,8%) sera with AB were positive only with CR (1 Ce, 1 E, 1 Leb, 1 C, 1 D, 1 Cob) and 9 (11,7%) only with ID (4 Lea, 1Fya, 1C, 2 P1, 1 D). Seven AB solely detected in ID only reacted in the bromelin test, besides an anti-Fya, which was an IgM antibody. The titration of IgG antibodies showed a significantly higher sensitivity of the CR (p=0,01). The ID showed clearly more unspecific reactions (1,1%) than the CR (0,5%) (p=0,02). DISCUSSION: The antibody screening with the ID proved to detect more AB than the CR (mainly due to certainly irrelevant "enzyme only" AB). On the other hand, relevant IgG AB werde detected more sensitive by the CR. Unspecific reactions appeared clearly more often in ID, predominantly when using the bromelin test. Missing a strong IgM anti-Fya in the CR is certainly an concern because of its assumed haemolytic activity. Therefore CR for antibody screening should always be combined with a method for crossmatching that safely detects IgM antibodies which are relevant for transfusion.