Background/Case Studies: Elution is a critical technique in immunohematology used to identify antibodies bound to red blood cells, particularly in cases of positive direct antiglobulin tests (DAT). Traditionally, a manual and time-intensive process, eluate testing can benefit from automation to improve efficiency and standardization. This retrospective study evaluates the performance and workflow impact of performing eluates on an automated immunohematology analyzer using solid phase technology following implementation in 2021.
Study
Design/Methods: Eluates were prepared from DAT-positive patient samples using standard acid elution protocols. The eluates were then tested on the instrument using antibody identification assays. Performance was assessed based on correlation with standard tube testing methods, turnaround time, hands-on time, reproducibility, and performance on proficiency surveys. The last wash of the patients’ red cells was tested by automated antibody detection assay, with a negative result required to ensure proper eluate preparation.
Results/Findings: The instrument successfully processed eluate samples with high concordance to manual methods. Automated testing produced accurate results for all Eluate proficiency surveys beginning in 2021. Turnaround time was reduced by an average of 16.5 minutes, and hands-on time decreased significantly, allowing technologists to focus on other critical tasks (see Table 1). The system demonstrated consistent and reproducible results across multiple runs. Integration into routine workflows was seamless, with minimal training required. Potential for error was also reduced by automating previously manual processes.
Conclusions: Automating eluate testing on the solid phase platform enhances efficiency, reduces manual labor, and maintains high diagnostic accuracy. This approach supports improved laboratory workflow and timely antibody identification, particularly in complex transfusion cases. Another advantage of performing eluates by the same method as the initial antibody detection and identification tests is that testing stays consistent by the same sensitive method as opposed to performing some testing by automated solid phase and other testing by the less sensitive tube method. Additionally automated testing reduces the potential for errors.
