The role of the direct antiglobulin test in pre-transfusion investigations and the approach to selecting blood for transfusion in autoimmune haemolytic anaemia: results of a regional survey.

Blood Transfusion = Trasfusione Del Sangue
Giancarlo Maria LiumbrunoRenato Vanacore

Abstract

The aim of this study was to conduct a Regional survey to determine the policies and ways of performing the direct antiglobulin test in pre-transfusion screening, the approach used in cases giving positive results with this test and the technical and operative modalities for choosing blood for transfusion in cases of autoimmune haemolytic anaemia. A questionnaire, containing ten multiple-choice questions, was sent to all the transfusion centres in the Region of Tuscany. The data from all 40 regional centres were analysed. Direct antiglobulin tests and autocontrols were not regularly used in pre-transfusion screening. The direct antiglobulin test was predominantly reserved for suspected cases of autoimmune haemolytic anaemia. Sixty percent of the laboratories characterised the specificity of samples that were positive for IgG and complement by the direct antiglobulin test, 45% that were positive for IgM, 35% also for IgA, and 13% also for subclasses of IgG. Elution studies were reserved (in 18% of laboratories) for those cases in which it was expected that transfusion therapy would be used. In cases of autoimmune haemolytic anaemia, autologous/allogeneic adsorption was carried out in 27% of the structures (the use of proteolytic...Continue Reading

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