(P-IN-3) Nothing Is Perfect: Three Blood Bank Analyzers-Comparing Antibody Sensitivities

Background/Case Studies: Patient care should always be a high priority, especially in transfusion services. Over the decades new techniques were developed to improve sensitivity, such as migrating from albumin to LISS, or PeG enhancements or by extending incubation times. Also, transitioning from the 2-cells to 3-cells antibody detection methods, which employ more double dose donor cells to detect the weaker reacting antibodies, that may lead to delayed hemolytic transfusion reactions. With the implementation of automated analyzers in the blood bank, the desire to continue focusing on antibody detection sensitivity for better patient care is still a high priority. This study was to the compare sensitivity for three instruments for antibody detection of clinically significant antibodies.

Study

Design/Methods: This study compared antibody detection during a week-long evaluation using 3 analyzers. Instruments included: current instrumentation, the Erytra (Grifols, Sant Cugat del Vallès, Spain), Vision Swift (QuidelOrtho, San Diego, CA) and Echo Lumena (Werfen, Norcross, GA). Randomly negative samples were selected from the facility based on adequate volume. Positive samples included: on-site Erytra samples plus samples shipped from an Echo & Vision hospital. Each facility included 4-8 random positive samples currently available, without duplicating patients. Eight additional samples were included to broaden the antibody specificity, Validation Panel (Werfen, Norcross, GA). All samples were randomized and tested in no specific order or instrument.

Results/Findings: Of the 93 samples collected, 6 were excluded due to clots or insufficient volume, leaving 87 tested. All instruments detected the validation samples, but varied results were obtained with patient specimens. The Erytra had the least sensitivity, 29% undetected antibodies, followed by the Vision with 10% undetected, while the Echo Lumena detected all clinically significant antibodies (100% detected). See Table 1.

Conclusions:
Patient care is a top priority for any hospital, especially decreasing the risk of delayed hemolytic transfusion reactions. Recently, some proficiency acceptability requirements increased from 80% to 100% for antibody detection. Therefore, incorporating a blood bank analyzer that uses a sensitive antibody detection method is important. This study compared instrument sensitivity with positive samples from facilities that currently used one of the three analyzers. Based on this study, it was determined that the Echo Lumena had the highest sensitivity (100%), Vision (90%) and the Erytra (71%) for detecting clinically significant antibodies. Due to the limited number of samples, if possible, we would like to expand this study to include more samples and specificities in the future.