COMPATIBILITY TESTING

Additional Information on Types of Compatibility

Tests
-

Manual (IS and IAT)

Gel Technology
Electronic (Computerized) Cross match
Red cell Affinity Column Technology
(ReACT)
Solid Phase Adherence Assays (SPAA)

Manual (IS and IAT)

The patient's ABO group and Rh type has

been done twice and entered in the
computer
The donor ABO/Rh have been confirmed
and entered in the computer. The donor
unit identification number, component
name, and ABO/Rh type must also be
entered in the computer
The computer system will alert the
technologist to ABO & Rh discrepancies
between information on the donor label
and results of donor confirmatory testing

Red Cell Affinity Column Technology (ReACT)

-

Based on affinity adherence of coated red

cells in an immunologically active matrix.
Antibody- sensitized red cells bind or
adsorbed to ligands attached to an
agarose matrix.
The main ligand is Protein G (prepared
from Group C or G Streptococcus or by
recombinant technology), which has high
affinity for all four IgG subclasses.
Another ReACT ligand is Protein A (from
Group A Staphylococcus), which binds to
IgG 1, 2, and 4.

Red Cell Affinity Column Technology (ReACT)

Gel Technology
-

Patient serum, and 1% of suspended RBCs

in LIM are dispensed into the microtube
and incubated at 37oC for 15 minutes.
The card containing the microtubes is then
centrifuged at a controlled speed for 10
minutes.
At the start of centrifugation the cells are
separated from the serum; then they meet
the AHG contained in the microtube.
Finally the cells are trapped by the gel (if
agglutinated) or pellet to the bottom of
the tube.

New Technologies
-

The electronic crossmatch

According to the AABB, the following must
be fulfilled:
Critical elements of the information
system have been validated onsite.
No clinically significant antibodies
are detected in the current blood
sample and there is no record of
clinically significant antibodies in
the past

Computer crossmatch (contd)

Positive reaction: the coated red blood

cells with IgG are boud to immunoreactive
gel particles, occurs mostly at the top of
the gel column.
Negative reaction: the red blood cells are
not coated with antibody and pass through
to the bottom of the gel column.

Solid Phase Adherence Assays (SPAA)

-

Uses red cell membrane bound to the

surfaces of polystyrene microtitration strip
wells, capturing IgG antibodies (if present)
in patient sera.
Patient serum is added to wells coated
with screen cells
Incubated at 37oC for 15 min.
Washing
anti-IgG-coated indicator red cells are
added.
centrifuge

SPAA
Result:
- Postive dispersed cells
- Negative indicator cells forming distinct
ring