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Introduction to Antibody Identification

Introduction to Antibody Identification Justin R. Rhees, , MLS(ASCP)CM,SBBCM University of Utah Medical Laboratory Sciences Objectives After this presentation the learner will be able to correctly: the clinical utility of Antibody Identification . the principle and procedure of the Antibody Identification tests. heterozygosity and homozygosity as they apply to Antibody Identification . allelic pairs in the following blood group systems: Rh, Duffy, Kidd, MNSs. patient test results, work through the Antibody Identification process. Antibody Screening and Identification Antibody screening is required: intended recipient of transfused blood. testing for obstetric patients: evaluates risk of HDFN and candidacy for RhIg of allogeneic blood and blood products and stem/progenitor cells.

of antibodies directed against antigens present on the cell. –(Rule out when the antigen is positive and the patient did not react) –Some antibodies demonstrate dosage. Dosage •Some antibodies may react so weakly with antigens with heterozygous expression, they

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Transcription of Introduction to Antibody Identification

1 Introduction to Antibody Identification Justin R. Rhees, , MLS(ASCP)CM,SBBCM University of Utah Medical Laboratory Sciences Objectives After this presentation the learner will be able to correctly: the clinical utility of Antibody Identification . the principle and procedure of the Antibody Identification tests. heterozygosity and homozygosity as they apply to Antibody Identification . allelic pairs in the following blood group systems: Rh, Duffy, Kidd, MNSs. patient test results, work through the Antibody Identification process. Antibody Screening and Identification Antibody screening is required: intended recipient of transfused blood. testing for obstetric patients: evaluates risk of HDFN and candidacy for RhIg of allogeneic blood and blood products and stem/progenitor cells.

2 Further testing ( Antibody ID) is required: the screen is newly positive alloantibody(ies) suspected Antibody Identification Methods for ABID Antibody Identification (ABID) can be performed in the following media: Traditional tube method Gel Technique Solid Phase Technique Antibody exclusion An exclusion procedure can be undertaken through observation of antigens present on reagent cells with which patient sera did not react. This means the patient s antibodies are not likely directed against the antigens present on those cells. Procedure Go to the first panel cell with a negative reaction, rule out or exclude the specificities of antibodies directed against antigens present on the cell. (Rule out when the antigen is positive and the patient did not react) Some antibodies demonstrate dosage.

3 Dosage Some antibodies may react so weakly with antigens with heterozygous expression, they might not be detected. For antibodies in the following blood groups, it may be prudent to rule out with panel cells that have a homozygous expression of antigen: Rhesus (excluding D) Kidd Duffy MNSs Dosage Dosage Mother Father Dosage Mother Father Dosage Mother Father Dosage Mother Father Dosage Mother Father Dosage Mother Father Dosage Mother Father Dosage Dosage Mother Father Dosage Mother Father Dosage Mother Father Dosage Mother Father Dosage Mother Father Dosage Mother Father Dosage Mother Father Dosage

4 Anti-Jka may not react with a heterozygous single dose cell It may only react with a cell that has double the dose of Jka antigens Allelic pairs Rh System C, c E, e Duffy System Fya, Fyb Kidd System Jka, Jkb MNSs System M, N S, s Antibody Identification Panel Rh-Hr Kell Duffy Kidd P MNSs Results D C c E e K k Fya Fyb Jka Jkb P1 M N S s 37 AHG CC 1 + 0 + + + 0 + 0 0 + + + + + 0 + 2 + 0 + 0 + 0 + 0 0 + 0 + + 0 0 + 3 + 0 + + 0 0 + 0 0 + 0 + 0 + + + 4 0 + 0 + + 0 + 0 0 + + 0 + 0 + + 5 0 0 + + + 0 + 0 0 0 + + 0 + 0 + 6 0 0 + 0 + 0 + 0 0 + 0 0 + 0 0 + 7 0 0 + 0 + + + 0 + 0 + 0 0 + + 0 8 + + + + + 0 + + + + + 0 + + 0 + AC Antibody Identification Panel Rh-Hr Kell Duffy Kidd P MNSs Results D C c E e K k Fya Fyb Jka Jkb P1 M N S s 37 AHG CC 1 + 0 + + + 0 + 0 0 + + + + + 0 + 0 2+ 2 + 0 + 0 + 0 + 0 0 + 0 + + 0 0 + 0 0 3 + 0 + + 0 0 + 0 0 + 0 + 0 + + + 0 2+ 4 0 + 0 + + 0 + 0 0 + + 0 + 0 + + 0 0 5 0 0 + + + 0 + 0 0 0 + + 0 + 0 + 0 2+ 6 0 0 + 0 + 0 + 0 0 + 0 0 + 0 0 + 0 0 7 0 0 + 0 + + + 0

5 + 0 + 0 0 + + 0 0 0 8 + + + + + 0 + + + + + 0 + + 0 + 0 2+ AC Antibody Identification Panel Rh-Hr Kell Duffy Kidd P MNSs Results D C c E e K k Fya Fyb Jka Jkb P1 M N S s 37 AHG CC 1 + 0 + + + 0 + 0 0 + + + + + 0 + 0 2+ 2 + 0 + 0 + 0 + 0 0 + 0 + + 0 0 + 0 0 3 + 0 + + 0 0 + 0 0 + 0 + 0 + + + 0 2+ 4 0 + 0 + + 0 + 0 0 + + 0 + 0 + + 0 0 5 0 0 + + + 0 + 0 0 0 + + 0 + 0 + 0 2+ 6 0 0 + 0 + 0 + 0 0 + 0 0 + 0 0 + 0 0 7 0 0 + 0 + + + 0 + 0 + 0 0 + + 0 0 0 8 + + + + + 0 + + + + + 0 + + 0 + 0 2+ AC Antibody Identification Panel Rh-Hr Kell Duffy Kidd P MNSs Results D C c E e K k Fya Fyb Jka Jkb P1 M N S s 37 AHG CC 1 + 0 + + + 0 + 0 0 + + + + + 0 + 0 2+ 2 + 0 + 0 + 0 + 0 0 + 0 + + 0 0 + 0 0 3 + 0 + + 0 0 + 0 0 + 0 + 0 + + + 0 2+ 4 0 + 0 + + 0 + 0 0 + + 0 + 0 + + 0 0 5 0 0 + + + 0 + 0 0 0 + + 0 + 0 + 0 2+ 6 0 0 + 0 + 0 + 0 0 + 0 0 + 0 0 + 0 0 7 0 0 + 0 + + + 0 + 0 + 0 0 + + 0 0 0 8 + + + + + 0 + + + + + 0 + + 0 + 0 2+ AC Antibody Identification Panel Rh-Hr Kell Duffy Kidd P MNSs Results D C c E e K k Fya Fyb Jka Jkb P1 M N S s 37 AHG CC 1 + 0 + + + 0 + 0 0 + + + + + 0 + 0 2+ 2 + 0 + 0 + 0 + 0 0 + 0 + + 0 0 + 0 0 3 + 0 + + 0 0 + 0 0 + 0 + 0 + + + 0 2+ 4 0 + 0 + + 0 + 0 0 + + 0 + 0 + + 0 0 5 0 0 + + + 0 + 0 0 0 + + 0 + 0 + 0 2+ 6 0 0 + 0 + 0 + 0 0 + 0 0 + 0 0 + 0 0 7 0 0 + 0 + + + 0 + 0 + 0 0 + + 0 0 0 8 + + + + + 0 + + + + + 0 + + 0 + 0 2+ AC Antibody Identification Panel Rh-Hr Kell Duffy Kidd P MNSs Results D C c E e K k Fya Fyb Jka Jkb P1 M N S s 37 AHG CC 1 + 0 + + + 0 + 0 0 + + + + + 0 + 0 2+ 2 + 0

6 + 0 + 0 + 0 0 + 0 + + 0 0 + 0 0 3 + 0 + + 0 0 + 0 0 + 0 + 0 + + + 0 2+ 4 0 + 0 + + 0 + 0 0 + + 0 + 0 + + 0 0 5 0 0 + + + 0 + 0 0 0 + + 0 + 0 + 0 2+ 6 0 0 + 0 + 0 + 0 0 + 0 0 + 0 0 + 0 0 7 0 0 + 0 + + + 0 + 0 + 0 0 + + 0 0 0 8 + + + + + 0 + + + + + 0 + + 0 + 0 2+ AC Antibody Identification Panel Rh-Hr Kell Duffy Kidd P MNSs Results D C c E e K k Fya Fyb Jka Jkb P1 M N S s 37 AHG CC 1 + 0 + + + 0 + 0 0 + + + + + 0 + 0 2+ 2 + 0 + 0 + 0 + 0 0 + 0 + + 0 0 + 0 0 3 + 0 + + 0 0 + 0 0 + 0 + 0 + + + 0 2+ 4 0 + 0 + + 0 + 0 0 + + 0 + 0 + + 0 0 5 0 0 + + + 0 + 0 0 0 + + 0 + 0 + 0 2+ 6 0 0 + 0 + 0 + 0 0 + 0 0 + 0 0 + 0 0 7 0 0 + 0 + + + 0 + 0 + 0 0 + + 0 0 0 8 + + + + + 0 + + + + + 0 + + 0 + 0 2+ AC Antibody Identification Panel Rh-Hr Kell Duffy Kidd P MNSs Results D C c E e K k Fya Fyb Jka Jkb P1 M N S s 37 AHG CC 1 + 0 + + + 0 + 0 0 + + + + + 0 + 0 2+ 2 + 0 + 0 + 0 + 0 0 + 0 + + 0 0 + 0 0 3 + 0 + + 0 0 + 0 0 + 0 + 0 + + + 0 2+ 4 0 + 0 + + 0 + 0 0 + + 0 + 0 + + 0 0 5 0 0 + + + 0 + 0 0 0 + + 0 + 0 + 0 2+ 6 0 0 + 0 + 0 + 0 0 + 0 0 + 0 0 + 0 0 7 0 0 + 0 + + + 0 + 0 + 0 0 + + 0 0 0 8 + + + + + 0 + + + + + 0 + + 0 + 0 2+ AC Antibody Identification Panel Rh-Hr Kell Duffy Kidd P MNSs Results D C c E e K k Fya Fyb Jka Jkb P1 M N S s 37 AHG CC 1 + 0 + + + 0 + 0 0 + + + + + 0 + 0 2+ 2 + 0 + 0 + 0 + 0 0 + 0 + + 0 0 + 0 0 3 + 0 + + 0 0 + 0 0 + 0 + 0 + + + 0 2+ 4 0 + 0 + + 0 + 0 0 + + 0 + 0 + + 0 0 5 0 0 + + + 0 + 0 0 0 + + 0 + 0 + 0 2+ 6 0 0 + 0 + 0 + 0 0 + 0 0 + 0 0 + 0 0 7 0 0 + 0 + + + 0 + 0 + 0 0 + + 0 0

7 0 8 + + + + + 0 + + + + + 0 + + 0 + 0 2+ AC Antibody Identification Panel Rh-Hr Kell Duffy Kidd P MNSs Results D C c E e K k Fya Fyb Jka Jkb P1 M N S s 37 AHG CC 1 + 0 + + + 0 + 0 0 + + + + + 0 + 0 2+ 2 + 0 + 0 + 0 + 0 0 + 0 + + 0 0 + 0 0 3 + 0 + + 0 0 + 0 0 + 0 + 0 + + + 0 2+ 4 0 + 0 + + 0 + 0 0 + + 0 + 0 + + 0 0 5 0 0 + + + 0 + 0 0 0 + + 0 + 0 + 0 2+ 6 0 0 + 0 + 0 + 0 0 + 0 0 + 0 0 + 0 0 7 0 0 + 0 + + + 0 + 0 + 0 0 + + 0 0 0 8 + + + + + 0 + + + + + 0 + + 0 + 0 2+ AC Antibody Identification Panel Rh-Hr Kell Duffy Kidd P MNSs Results D C c E e K k Fya Fyb Jka Jkb P1 M N S s 37 AHG CC 1 + 0 + + + 0 + 0 0 + + + + + 0 + 0 2+ 2 + 0 + 0 + 0 + 0 0 + 0 + + 0 0 + 0 0 3 + 0 + + 0 0 + 0 0 + 0 + 0 + + + 0 2+ 4 0 + 0 + + 0 + 0 0 + + 0 + 0 + + 0 0 5 0 0 + + + 0 + 0 0 0 + + 0 + 0 + 0 2+ 6 0 0 + 0 + 0 + 0 0 + 0 0 + 0 0 + 0 0 7 0 0 + 0 + + + 0 + 0 + 0 0 + + 0 0 0 8 + + + + + 0 + + + + + 0 + + 0 + 0 2+ AC Antibody Identification Panel Rh-Hr Kell Duffy Kidd P MNSs Results D C c E e K k Fya Fyb Jka Jkb P1 M N S s 37 AHG CC 1 + 0 + + + 0 + 0 0 + + + + + 0 + 0 2+ 2 + 0 + 0 + 0 + 0 0 + 0 + + 0 0 + 0 0 3 + 0 + + 0 0 + 0 0 + 0 + 0 + + + 0 2+ 4 0 + 0 + + 0 + 0 0 + + 0 + 0 + + 0 0 5 0 0 + + + 0 + 0 0 0 + + 0 + 0 + 0 2+ 6 0 0 + 0 + 0 + 0 0 + 0 0 + 0 0 + 0 0 7 0 0 + 0 + + + 0 + 0 + 0 0 + + 0 0 0 8 + + + + + 0 + + + + + 0 + + 0 + 0 2+ AC Antibody Identification Panel Rh-Hr Kell Duffy Kidd P MNSs Results D C c E e K k Fya Fyb Jka Jkb P1 M N S s 37 AHG CC 1 + 0 + + + 0 + 0 0 + + + + + 0 + 0 2+ 2 + 0 + 0 + 0 + 0 0 + 0

8 + + 0 0 + 0 0 3 + 0 + + 0 0 + 0 0 + 0 + 0 + + + 0 2+ 4 0 + 0 + + 0 + 0 0 + + 0 + 0 + + 0 0 5 0 0 + + + 0 + 0 0 0 + + 0 + 0 + 0 2+ 6 0 0 + 0 + 0 + 0 0 + 0 0 + 0 0 + 0 0 7 0 0 + 0 + + + 0 + 0 + 0 0 + + 0 0 0 8 + + + + + 0 + + + + + 0 + + 0 + 0 2+ AC Antibody Identification Panel Rh-Hr Kell Duffy Kidd P MNSs Results D C c E e K k Fya Fyb Jka Jkb P1 M N S s 37 AHG CC 1 + 0 + + + 0 + 0 0 + + + + + 0 + 0 2+ 2 + 0 + 0 + 0 + 0 0 + 0 + + 0 0 + 0 0 3 + 0 + + 0 0 + 0 0 + 0 + 0 + + + 0 2+ 4 0 + 0 + + 0 + 0 0 + + 0 + 0 + + 0 0 5 0 0 + + + 0 + 0 0 0 + + 0 + 0 + 0 2+ 6 0 0 + 0 + 0 + 0 0 + 0 0 + 0 0 + 0 0 7 0 0 + 0 + + + 0 + 0 + 0 0 + + 0 0 0 8 + + + + + 0 + + + + + 0 + + 0 + 0 2+ AC Antibody Identification Panel Rh-Hr Kell Duffy Kidd P MNSs Results D C c E e K k Fya Fyb Jka Jkb P1 M N S s 37 AHG CC 1 + 0 + + + 0 + 0 0 + + + + + 0 + 0 2+ 2 + 0 + 0 + 0 + 0 0 + 0 + + 0 0 + 0 0 3 + 0 + + 0 0 + 0 0 + 0 + 0 + + + 0 2+ 4 0 + 0 + + 0 + 0 0 + + 0 + 0 + + 0 0 5 0 0 + + + 0 + 0 0 0 + + 0 + 0 + 0 2+ 6 0 0 + 0 + 0 + 0 0 + 0 0 + 0 0 + 0 0 7 0 0 + 0 + + + 0 + 0 + 0 0 + + 0 0 0 8 + + + + + 0 + + + + + 0 + + 0 + 0 2+ AC Antibody Identification Panel Rh-Hr Kell Duffy Kidd P MNSs Results D C c E e K k Fya Fyb Jka Jkb P1 M N S s 37 AHG CC 1 + 0 + + + 0 + 0 0 + + + + + 0 + 0 2+ 2 + 0 + 0 + 0 + 0 0 + 0 + + 0 0 + 0 0 3 + 0 + + 0 0 + 0 0 + 0 + 0 + + + 0 2+ 4 0 + 0 + + 0 + 0 0 + + 0 + 0 + + 0 0 5 0 0 + + + 0 + 0 0 0 + + 0 + 0 + 0 2+ 6 0 0 + 0 + 0 + 0 0 + 0 0 + 0 0 + 0 0 7 0 0 + 0 + + + 0 + 0 + 0 0 + + 0 0 0 8 + + + + + 0

9 + + + + + 0 + + 0 + 0 2+ AC Antibody Identification Panel Rh-Hr Kell Duffy Kidd P MNSs Results D C c E e K k Fya Fyb Jka Jkb P1 M N S s 37 AHG CC 1 + 0 + + + 0 + 0 0 + + + + + 0 + 0 2+ 2 + 0 + 0 + 0 + 0 0 + 0 + + 0 0 + 0 0 3 + 0 + + 0 0 + 0 0 + 0 + 0 + + + 0 2+ 4 0 + 0 + + 0 + 0 0 + + 0 + 0 + + 0 0 5 0 0 + + + 0 + 0 0 0 + + 0 + 0 + 0 2+ 6 0 0 + 0 + 0 + 0 0 + 0 0 + 0 0 + 0 0 7 0 0 + 0 + + + 0 + 0 + 0 0 + + 0 0 0 8 + + + + + 0 + + + + + 0 + + 0 + 0 2+ AC Antibody Identification Panel Rh-Hr Kell Duffy Kidd P MNSs Results D C c E e K k Fya Fyb Jka Jkb P1 M N S s 37 AHG CC 1 + 0 + + + 0 + 0 0 + + + + + 0 + 0 2+ 2 + 0 + 0 + 0 + 0 0 + 0 + + 0 0 + 0 0 3 + 0 + + 0 0 + 0 0 + 0 + 0 + + + 0 2+ 4 0 + 0 + + 0 + 0 0 + + 0 + 0 + + 0 0 5 0 0 + + + 0 + 0 0 0 + + 0 + 0 + 0 2+ 6 0 0 + 0 + 0 + 0 0 + 0 0 + 0 0 + 0 0 7 0 0 + 0 + + + 0 + 0 + 0 0 + + 0 0 0 8 + + + + + 0 + + + + + 0 + + 0 + 0 2+ AC Antibody Identification Panel Rh-Hr Kell Duffy Kidd P MNSs Results D C c E e K k Fya Fyb Jka Jkb P1 M N S s 37 AHG CC 1 + 0 + + + 0 + 0 0 + + + + + 0 + 0 2+ 2 + 0 + 0 + 0 + 0 0 + 0 + + 0 0 + 0 0 3 + 0 + + 0 0 + 0 0 + 0 + 0 + + + 0 2+ 4 0 + 0 + + 0 + 0 0 + + 0 + 0 + + 0 0 5 0 0 + + + 0 + 0 0 0 + + 0 + 0 + 0 2+ 6 0 0 + 0 + 0 + 0 0 + 0 0 + 0 0 + 0 0 7 0 0 + 0 + + + 0 + 0 + 0 0 + + 0 0 0 8 + + + + + 0 + + + + + 0 + + 0 + 0 2+ AC Antibody Identification Panel Rh-Hr Kell Duffy Kidd P MNSs Results D C c E e K k Fya Fyb Jka Jkb P1 M N S s 37 AHG CC 1 + 0 + + + 0 + 0 0 + + + + + 0 + 0 2+ 2 + 0 + 0 + 0 + 0 0 + 0 + + 0 0 + 0 0 3

10 + 0 + + 0 0 + 0 0 + 0 + 0 + + + 0 2+ 4 0 + 0 + + 0 + 0 0 + + 0 + 0 + + 0 0 5 0 0 + + + 0 + 0 0 0 + + 0 + 0 + 0 2+ 6 0 0 + 0 + 0 + 0 0 + 0 0 + 0 0 + 0 0 7 0 0 + 0 + + + 0 + 0 +

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