For this typing, I always had both automated and manual methods set up on the blood bank computer system Medinfo Hematos IIG. The automated method had a bidirectional interface between Medinfo and the instrument. Medinfo did not need a separate middleware. A truth table was prepared for acceptable results for automatic interpretation. Other results had to be manually interpreted by someone with the appropriate security level.
It was standard in my donor processing laboratory that extended Rh typing (EeCc) and Kell were performed. We were in a region with many sickle cell and thalassemia patients. Having all RBC units pre-typed in the Blood Donor Center expedited selection and release in the hospital blood bank—especially for matching K-negative units to K-negative patients and extended Rh phenotypes for sickle cell patients.
The manual testing option is structured similarly. Within Medinfo, it is easy to change the methodology or have more than one methodology if the system is so built. Thus, if the analyzer for this typing was down, the staff could select the manual methodology. Likewise, if one testing center went off-line, the work could be completed at another site—no need to repeat testing already completed from the first site. This flexibility could apply to any test in system.
The manufacturer’s recommendations for the particular reagents in use were strictly followed. Most importantly, Medinfo can be configured for any set of reagent values.
Please refer to the sample flowchart which also includes Cw and DVI+ typing. The same process could apply to patient testing, but some reagents would use a DVI- reagent.