Blood Bank Automation for Transfusion Services

Question 1

What are the tests under “Immediate Spin”?

Answer 1

-ABO
-Rh
-Donor confirmation

Question 2

Whare are the blood bank tests under “Indirect Antiglobulin Test” (IAT)?

Answer 2

*Antibody Screen
* IgG Crossmatch
* Phenotype
*Weak D
*Antibody Identification

Question 3

Two additional blood bank tests?

Answer 3

-IgG Direct Antiglobulin Test (DAT)
-CMV

Question 4

What testing is the gold standard in blood bank?

Answer 4

tube testing!

Question 5

What are the benefits of automation?

Answer 5

• Reduction in
  operating costs
• Redesign of work
  processes and
  support systems
• Increased
  productivity
• Enhanced total
  quality

Question 6

What are the challenges of automation?

Answer 6

-Job replacement
-staff Involvement in decision making
-cost justification issues
-time investment
-training and validation may require extra staff

Question 7

Who regulates automated laboratory equipment?

Answer 7

-CAP
-FDA

Question 8

Automation should meet the criteria for what three things?

Answer 8

criteria for testing, sample handling, and data handling

Question 9

What does random-access mode mean?

Answer 9

samples can be added at anytime

Question 10

In blood bank, automated systems have been developed for…

What can the instruments perform?

Answer 10

• SPRCA assays * Microtiter plates * Gel technology
• ABO and Rh testing * Antibody detection and identification * Crossmatching

Question 11

• Assays are performed on microplates using the
  same principles as in tube agglutination
• Bar-coded samples and reagents are used
• Plates are automatically read using a camera
  reader

Answer 11

Hemagglutination
Assays

Question 12

SPRCA assays are used for both __________
antiglobulin tests (IATs) and _________
antiglobulin tests (DATs)

Answer 12

Indirect, direct

Question 13

Microtiter wells have RBC membranes bound
to the surface

• Patient antibodies (if present) will attach to the
  corresponding antigen covering the well
  *Negative results form a button at the bottom of the well
• Capture-R Select® assay system immobilizes RBCs other than screen or panel cells

Answer 13

SPRCA Assays

Question 14

How are SPRCA assay results different from tube testing?

Answer 14

cell button = negative test

Question 15

What are the steps in SPRCA assays?

Answer 15

-Use microtiter plate coated with antigen coated wells
-add plasma or serum with LISS
-incubate at 37 degrees Celsius
-wash (unbound will be washed away, while antibody being tested will stay intact on well surface)
-add indicator red cells (nonspecific IgG?)
-centrifuge
-unbound will clump up to produce “button”, indicating negative test, positive will stay attached and stay disbursed

Question 16

-assay that detects RBC antibodies in
serum or plasma
-Wells are precoated with protein A, which has a
high affinity for the Fc portion of immunoglobulins

Answer 16

Solidscreen II

Question 17

What is a positive and negative test look like for Solidscreen II test?

Answer 17

Positive test: RBCs and antibody to immunoglobulin G (antiIgG antibody) bind with protein A, forming a smooth
monolayer
* Negative test: RBCs form a button at the bottom of the well

Question 18

What are the steps in Solidscreen II testing?

Answer 18

-sample, LISS and RBC are pipetted into wells (pre-coated with protein A)
-incubation at 37 degrees Celsius
-Wash with diluted wash solution then anti-human globulin added
-centrifugation
-read results (“button” = negative)

Question 19

• Hemagglutination assay
• ABO, D, and other RBC
  antigen testing
• Monoclonal antisera are
  dried in microwells

(anti-sera dissolves off the well?)

Answer 19

Erytype S

Question 20

TANGO™ Infinity (Bio-Rad) combines ___________ and _____________.

Answer 20

Erytype S, Solidscreen II

Question 21

What are two automated SPRCA Systems?

Answer 21

TANGO™ Infinity (Bio-Rad)

Capture™ system (Immucor)
-Microtiter plates accommodate
SPRCA or hemagglutination
testing

*both solid phase

Question 22

What are the benefits of ORTHO ProVue®?

Answer 22

• Eliminates time-consuming processes
• Increases productivity
• Enhances process control

Question 23

What are the tests used withORTHO ProVue®?

Answer 23

• Agglutination: ABO and D, Rh phenotyping, IS crossmatching
• DAT: anti-IgG, anti-IgG-C3d antibodies
• IAT: antibody screening and identification, IAT crossmatching

Question 24

What are the components of ORTHO ProVue®?

Answer 24

computer, software, instrument, bar-code
scanner, printer

Question 25

How many cameras does ORTHO ProVue have?

Answer 25

3

Question 26

What is the automated Gel system called?

Answer 26

ID-MTS™ Gel Test (Ortho Clinical Diagnostics)

• Automated instrument is ORTHO ProVue®

Question 27

-dose not have a wash step
-dose not need to be diluted or saline

Answer 27

gel testing