Convert to AGT.
(d) If "(a)" is not used, an enzyme method may be valuable.
b. Various combinations may be used as long as the requirement of detecting
hemolyzing, agglutinating, and coating antibodies is ensured.
c. The detection tests will indicate the methods to use for identification of the
antibody. All methods showing positive results in the detection tests should be used in
the identification tests. Each method could be detecting a different specificity rather
than one specificity reacting by several methods.
1-32. ANTIBODY IDENTIFICATION
a. Determine the specificity of an antibody, both positive and negative reactions
with the panel cells should be found. As noted in para 1-27c, a good panel should do
this for most single and many multiple antibodies.
b. Preliminary testing includes ABO grouping, including the use of anti-A1,
anti-A, B, cells and A2 cells (if indicated), Rh phenotyping, and a direct antiglobulin test.
In addition, the following may be helpful: results of previous testing; history of
transfusion or pregnancy; patient's diagnosis; drug therapy (including Rh immune
globulin); and results of tests for whatever RBC antigens may appear to be pertinent.
Preferably, these tests should be done on a pretransfusion sample; otherwise,
interpretation of results is very difficult.
c. Especially useful from previous test results are such data as the effect of
temperature, suspending medium, or enzyme treatment; the frequency of positive
reactions with cells of random donors; the strength of positive reactions; the presence of
hemolysls; and whether the antibodies appear to detect dosage.
1-33. USE OF RED BLOOD CELL PANELS
a. Each panel should be provided with a worksheet. The antigens for which the
cells have been tested are listed across the top of the sheet. After the results of the
reactions of the serum being tested have been recorded, the first cell showing no
reactions is considered. The antigens present on the nonreactive cell are crossed out
on the list at the top of the worksheet. Each nonreactive cell is interpreted in this
manner. When all nonreactive cells have been considered, those antigens remaining
on the list are circled.
b. If one antibody is present, all cells containing that antigen should be positive,
and all cells lacking the antigen should be negative. If multiple antibodies are present in
the serum, the addition of selected cells may be necessary.