Effect of donor blood storage on gel column crossmatch in dogs

Abstract

Background Compared with fresh blood, stored equine donor blood results in spurious tube crossmatch incompatibilities. Interpretation of blood crossmatch results is considered subjective. Objectives We aimed to determine if the duration of canine donor blood storage impacts compatibility testing using a standard gel column crossmatch and evaluate interobserver variation in the interpretation of crossmatch results. Methods Observational study. Whole blood segments were obtained from 23 canine packed red blood cell (RBC) units for use in crossmatches after storage for 0, 7, 14, 21, 28, and 35 days. Major and minor crossmatches were performed using serum and RBCs, respectively, from two to three healthy “recipient” dogs per unit. All crossmatch results were interpreted by four observers, of whom three were blinded. Results All major crossmatches (n = 61) were compatible on day 0 and remained compatible through day 35 of storage. All minor crossmatches (n = 69) were compatible at all time points, except for five donor pairs with 1 to 3+ agglutination. Repeat testing of these five donor pairs confirmed crossmatch incompatibilities on days 0 through 35, with no change in the degree of incompatibility over time. There was substantial agreement among four observers in determining compatibility (κ = 0.94) and scoring incompatibility (κ = 0.76). Conclusions The current practice of performing canine crossmatches with whole blood segments stored for up to 35 days is acceptable, with no spurious changes in compatibility expected over time. The substantial interobserver agreement suggests that the gel column is suitable for performing canine crossmatches in a laboratory setting with multiple personnel.

Evaluation of post-transfusion RBC alloimmunization in dogs using a gel-column crossmatch with and without anti-canine globulin enhancement

“…12 Interpretation of crossmatch results is somewhat subjective with respect to grading the degree of incompatibility. In our study, which included a total of 562 gel columns, there was near-perfect agreement (97%) among 4 observers in determining compatibility, similar to results of our previous canine study 29 and an equine study 4 using the gel-column crossmatch method. For the individual scores (1-4+), there was substantial agreement (73%) only for an incompatibility score of 4+, defined as all RBCs being agglutinated and remaining on the top of the gel column.…”

“…The gel-column crossmatch is used commonly in human transfusion medicine 8 and has been documented to have near-perfect agreement among observers for determination of blood com-patibility in horses 4 and dogs. 29 Blood crossmatch kits containing gel tubes or immunochromatographic strips, both with and without ACG, have been developed for in-clinic use. Crossmatch methods to detect naturally occurring or post-transfusion RBC alloantibodies in dogs have been compared in several studies, with variable results.…”

The Indirect Antiglobulin (Coombs’) Test Is Specific but Less Sensitive Than the Direct Antiglobulin Test for Detecting Anti-Erythrocytic Autoantibodies and Thereby Immune-Mediated Hemolytic Anemia in Dogs

“…Indirect antiglobulin test (IAT) results from 94 dogs suspected to have immune-mediate hemolytic anemia with the gel column laboratory (GEL LAB) method and three different antiglob ulins: polyvalent IgG, IgM, and C3 goat-anti-dog (GAD); polyvalent IgG, IgM, and C3 rabbit-ant dog (RAD); and monovalent IgG rabbit-anti-dog (IgG). Grading of test results according to gel co umn manufacturer from − to 4+ [37,38]. In contrast, the GEL LAB IAT with any of the three reagents at 22 • C detected only ≤17% of the DAT+ dogs.…”

“…Indirect antiglobulin test (IAT) results from 94 dogs suspected to have immune-mediated hemolytic anemia with the gel column laboratory (GEL LAB) method and three different antiglobulins: polyvalent IgG, IgM, and C3 goat-anti-dog (GAD); polyvalent IgG, IgM, and C3 rabbit-anti-dog (RAD); and monovalent IgG rabbit-anti-dog (IgG). Grading of test results according to gel column manufacturer from − to 4+ [37,38]. 12.8 97.9 0.10 Poor None 1 Cohen's kappa (κ) interpretation as per Landis and Koch [28] adapted by Brennan [29]: very good agreement (≥0.81); good agreement (≥0.61); moderate agreement (≥0.41); fair agreement (≥0.21), poor agreement (≤0.2).…”