University of Virginia Health System Charlottesville, Virginia, United States
Background/Case Studies: Ensuring accurate antibody detection is vital for safe transfusion practices. The solid-phase and gel-based methods are widely used in transfusion services for antibody screening and identification. Werfen’s (Norcross, Ga) Capture method, a solid-phase red cell adherence assay (SPRCA) has been reported to exhibit high sensitivity in detecting clinically significant antibodies. Grifols’ (Barcelona, Sp) gel method, a column agglutination-based technology (CAT), is a widely used alternative for routine transfusion testing. As immunohematology advances and new analyzers become available, it is essential to assess whether adopting a new method supports the lab’s workflow and improves transfusion safety. This study compares the sensitivity of solid-phase and gel-based methods to assess their performance in antibody detection and guide decision-making on adopting a new analyzer in the Transfusion Service.
Study
Design/Methods: Twelve samples with known or newly identified antibodies were initially detected using the solid-phase Capture method on the Echo Lumena, then retested using the gel-based method on the Grifols Erytra automated analyzer. The study assessed the gel method ability to detect these antibodies by comparing its results to the established solid-phase method. Each sample was processed according to the manufacturer’s guidelines, and results were evaluated for concordance, discrepancies, and overall detection efficiency. Discordant findings underwent further serological testing to determine possible causes of variance. The performance of the gel method was evaluated based on its ability to accurately detect clinically significant antibodies.
Results/Findings: Of the twelve samples tested, three showed no reactivity using the gel-based method compared to the initial solid-phase testing. These antibodies included Anti-Jka, passive Anti-D, and Anti-c. To confirm ongoing reactivity, the samples were retested using the Echo Lumena, reaffirming antibody presence. The remaining nine samples demonstrated consistent reactivity with both methods. Notably, one sample that showed both Anti-E and Anti-Jka in solid-phase testing displayed only Anti-E in gel testing.
Conclusions: In this limited comparison, the solid-phase method appeared more sensitive than the gel-based method in detecting clinically significant antibodies, particularly those frequently encountered at this facility. These results underscore the value of conducting side-by-side comparisons when evaluating a new testing platform. While the gel-based method offers perceived advantages such as workflow efficiency, this study found a 33% discrepancy in antibody detection when compared to the solid-phase method. Based on these findings, the facility concluded that retaining the solid-phase platform currently best supports its operational and clinical needs.
