Impact and relevance of the inclusion of the Enzymatic Irregular Antibody Survey associated with the Liss/Coombs Irregular Antibody Survey technique in the transfusion routine
Erythrocyte alloimmunization is a very common problem, especially in those who transfuse chronically. The Irregular Antibody Survey (IAP) is a technique that helps in the detection of erythrocyte alloantibodies and must be sensitive to detect them and prevent transfusion reaction. The study aimed to evaluate the impact of the inclusion of enzymatic PAI in comparison with the Liss/Coombs technique. We evaluated 70 patients who underwent a chronic transfusion regimen at the outpatient clinic of the Hemotherapy Service between April 21 and July 12, 2021. Among the 70 patients analyzed, most were in group A positive (23 - 32.8%), and O positive (22 - 31.4%). AIP positivity in at least one of the techniques was 22 (31.4%). A total of 48 patients had negative PAI in both Liss/Coombs and enzyme (68.6%) and 10 with positive PAI in Liss/Coombs and enzyme (14.3%). AIP results were in agreement in 10 (14.3%) patients and discordant in 12 (17.1%). According to the interpretation of the enzymatic red blood cell panel, antibody identification was conclusive in two patients, one with anti-C and the other with anti-E, and indeterminate in five patients. On the other hand, 5 (7.1%) patients who already had positive PAI in Liss/Coombs did not obtain positivity in enzymatic PAI, being one with anti-Dia, one with anti-K plus anti-Kpa and three with indeterminate antibody. With the inclusion of the enzymatic test, an increase in the positivity of PAI for antibodies of clinical significance was verified. It is important to assess the cost-effectiveness of including this test as the technique detects a large proportion of antibodies without specificity and/or clinical relevance.
Impact and relevance of the inclusion of the Enzymatic Irregular Antibody Survey associated with the Liss/Coombs Irregular Antibody Survey technique in the transfusion routine
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DOI: 10.22533/at.ed.1592722217115
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Palavras-chave: blood transfusion, alloantibodies, transfusion safety, enzyme test
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Keywords: blood transfusion, alloantibodies, transfusion safety, enzyme test
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Abstract:
Erythrocyte alloimmunization is a very common problem, especially in those who transfuse chronically. The Irregular Antibody Survey (IAP) is a technique that helps in the detection of erythrocyte alloantibodies and must be sensitive to detect them and prevent transfusion reaction. The study aimed to evaluate the impact of the inclusion of enzymatic PAI in comparison with the Liss/Coombs technique. We evaluated 70 patients who underwent a chronic transfusion regimen at the outpatient clinic of the Hemotherapy Service between April 21 and July 12, 2021. Among the 70 patients analyzed, most were in group A positive (23 - 32.8%), and O positive (22 - 31.4%). AIP positivity in at least one of the techniques was 22 (31.4%). A total of 48 patients had negative PAI in both Liss/Coombs and enzyme (68.6%) and 10 with positive PAI in Liss/Coombs and enzyme (14.3%). AIP results were in agreement in 10 (14.3%) patients and discordant in 12 (17.1%). According to the interpretation of the enzymatic red blood cell panel, antibody identification was conclusive in two patients, one with anti-C and the other with anti-E, and indeterminate in five patients. On the other hand, 5 (7.1%) patients who already had positive PAI in Liss/Coombs did not obtain positivity in enzymatic PAI, being one with anti-Dia, one with anti-K plus anti-Kpa and three with indeterminate antibody. With the inclusion of the enzymatic test, an increase in the positivity of PAI for antibodies of clinical significance was verified. It is important to assess the cost-effectiveness of including this test as the technique detects a large proportion of antibodies without specificity and/or clinical relevance.
- Luciana do Nascimento Vargas
- Laís Oliveira Garcia
- Ernestina Aguiar
- Samantha Brum Leite
- Leo Sekine5
