This study provided quantitative evidence on how automation could transform pretransfusion testing processes by dramatically reducing error potentials and thus would improve the safety of blood transfusion.

Currently, the goal of testing for RBC antibodies is to use a method that will detect, if possible, all antibodies that are considered clinically significant and yet not detect antibodies of little clinical importance in transfusion or pregnancy. The focus of test method development has been on the more controllable variables of the first and second stages of agglutination. Tube test methods have been developed over the years to achieve shorter turnaround times for quicker test results and improved sensitivity, with the occasional negative impact on relevant results. The focus on improving efficiency through automation, and personnel resourcing challenges of the transfusion service, have led laboratories to select methods tailored to meet their needs. This review compares the newer methods used in the gel test and solid phase test with commonly used tube methods. Both of the newer methods were developed with future adaptation to automation in mind. Further literature reviews about antibodies detected in only one or two methods and their general lack of clinical relevance as well as the occasional rare examples that produce significant clinical effects on transfused patients are also discussed. Immunohematology 2006;22:196–202.

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Immunoglobulin therapy that interferes with pretransfusion testing may complicate the interpretation of test results and adversely affect patient management. Rh immune globulin (RhIG) should be considered an interfering immunoglobulin therapy when it is detected in an antibody detection test of a sample from a patient who has been treated with RhIG. Frequently, detection occurs in mother's or newborn's plasma. Because an antenatal injection of RhIG is indicated for pregnant Rh-negative women, anti-D is detected frequently by today's highly sensitive antibody screen methods when the mother's plasma is tested subsequently at delivery. Ascertaining the source of anti-D is complicated by the inability of routine clinical laboratory methods to distinguish anti-D due to RhIG from alloimmune anti-D. A combination of qualitative and quantitative test methods, as well as a complete clinical history, is necessary for accurate diagnosis and patient management. Immunohematology 2019:35;51-60.

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