9. Trouble-shooting and problem-solving in the reference laboratory

  1. Geoff Daniels PhD, FRCPath Consultant Clinical Scientist and Head of Diagnostics1 and
  2. Imelda Bromilow MSc, CBiol Scientific Consultant2

Published Online: 6 SEP 2013

DOI: 10.1002/9781118688915.ch9

Essential Guide to Blood Groups, Third Edition

Essential Guide to Blood Groups, Third Edition

How to Cite

Daniels, G. and Bromilow, I. (eds) (2013) Trouble-shooting and problem-solving in the reference laboratory, in Essential Guide to Blood Groups, Third Edition, John Wiley & Sons, Oxford. doi: 10.1002/9781118688915.ch9

Editor Information

  1. 1

    IBGRL, Bristol Institute for Transfusion Services, NHS Blood and Transplant, Bristol, UK

  2. 2

    Liverpool, UK

Publication History

  1. Published Online: 6 SEP 2013
  2. Published Print: 3 SEP 2013

ISBN Information

Print ISBN: 9781118688922

Online ISBN: 9781118688915

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Keywords:

  • ABO grouping;
  • antibody screening;
  • crossmatching;
  • dithiothreitol (DTT);
  • reference laboratory;
  • Rh grouping

Summary

This chapter discusses trouble-shooting and problem-solving in the reference laboratory for ABO grouping, Rh grouping and problems in antibody screening, identification, and crossmatching. ABO groups should be assigned only when the forward and reverse groupings concur and when the group obtained is identical to either historical records or the results of a second ABO test. The chapter outlines some additional information regarding original reactions by IAT and further investigations that can be considered in order to determine antibody specificity. Some antibodies may be characterized based on reactions with papain-treated red cells in parallel with dithiothreitol (DTT) treatment. Reference laboratories may perform additional tests in order to identify or confirm the presence of antibodies such as by the use of cord cells, lacking or having weak expression of certain antigens, or by the use of human body fluids known to neutralise certain antibodies.