Principle:

Historically, the Lui-Freeze-Thaw elution method was used to detect ABO antibodies in suspected cases of ABO hemolytic disease of the fetus/newborn HDFN.  However, the detection of such antibodies does not mean that they are clinically significant.  If a clinically significant antibody is suspected, perform acid elution instead.  If you want to detect ABO antibodies in a neonate or in a transplant setting, you can use this eluate against reagent A and B cells.

Policy:

1. For suspected cases of significant ABO antibodies (HDFN, organ transplant), perform acid-elution:
   1. For ABO antibodies, test the eluate against reagent A and B cells using antiglobulin phase.
      1. If the mother is ABO-incompatible with the neonate and the neonate’s DAT is positive with a negative eluate against panel cells, then test against A and B cells to rule out ABO antibodies
      2. The same applies to organ transplant cases to detect ABO antibodies.
2. For detection of non-ABO antibodies, test the eluate against an antibody panel (i.e. group O cells).

References:

1. Technical Manual, Current Edition, AABB, Bethesda, MD, USA
2. Standards for Blood Banks and Transfusion Services, Current Edition, AABB, Bethesda, MD, USA
3. Guidelines to the Preparation, Use, and Quality Assurance of Blood Components, European Committee (Partial Agreement) on Blood Transfusion (CD-P-TS), Current Edition