Immunohematology and Genetic Testing (red cells, leukocytes and platelets)
Cristina Coll-Ortega, n/a (she/her/hers)
Grifols SA, Catalonia, Spain
Immunohematology (IH) tests are performed to evaluate compatibility of blood types between donor and patient and to minimize the risk of transfusion reactions. Automated pretransfusion blood testing has become the mainstay since the commercialization of IH analyzers, because of their reduced risk of human error and increased efficiency. Our aim was to assess the concordance of results between commercially available IH analyzers.
Study
Design/Methods:
A systematic literature review of studies evaluating the concordance of ABO/RhD typing, antibody (Ab) screening or Ab identification results from a minimum of two IH analyzers was performed on April 2023. Searches were conducted in PubMed and Embase for peer reviewed manuscripts published between 2006 and 2023. Conference abstracts published in ISBT, AABB, BBTS and AACC between 2021 and 2022 were reviewed and included, if eligible. IH analyzers and tests were grouped by companies (Grifols, Ortho, Immucor and BioRad) for analysis. Concordance results of 1:1 comparisons between IH analyzers were meta-analyzed using a generalized linear mixed model.
Results/Findings:
Twenty-six studies were included (17 for ABO/RhD typing, 20 for Ab screening and 12 for Ab identification). Five studies were identified from peer-reviewed journals and 21 from conference abstracts. The estimated pooled concordance rates for 1:1 comparisons ranged between 99.0%-100%, 98.9%-99.7% and 71.2%-97.5% for ABO/RhD typing, Ab screening and Ab identification, respectively (Table 1).
Conclusions:
Estimated concordance rates for ABO/RhD typing and Ab screening are close to 100% for 1:1 comparisons, suggesting similar performance across all commercially available IH analyzers. In contrast, concordance rates for Ab identification show larger heterogeneity. Differences observed may be explained by the variable ability of IH analyzers to identify specific Abs, the variation in reagent cells for Ab identification, the variable expertise of lab technicians involved in the studies, or a combination of these factors.