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:
- For suspected cases of significant ABO antibodies (HDFN, organ transplant), perform acid-elution:
- For ABO antibodies, test the eluate against reagent A and B cells using antiglobulin phase.
- 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
- The same applies to organ transplant cases to detect ABO antibodies.
- For ABO antibodies, test the eluate against reagent A and B cells using antiglobulin phase.
- For detection of non-ABO antibodies, test the eluate against an antibody panel (i.e. group O cells).
References:
- Technical Manual, Current Edition, AABB, Bethesda, MD, USA
- Standards for Blood Banks and Transfusion Services, Current Edition, AABB, Bethesda, MD, USA
- Guidelines to the Preparation, Use, and Quality Assurance of Blood Components, European Committee (Partial Agreement) on Blood Transfusion (CD-P-TS), Current Edition