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ABO/Rh, Blood Type

Test Code: 30832

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Clinical Utility

ABO, Blood Type
Blood typing using manual Immucor typing reagents and/or the Immucor NEO platform. Samples will be tested using a method appropriate for that sample type and condition: |Manual ABO/Rh Reagents: Tube Method |NEO ABO: Plate Method |NEO Weak D (Rh): Solid Red Cell Adherence.

ABO, Anti-A, Anti-B, Anti-A,B
Immucor Anti-A Series 1 (Murine Monoclonal), Anti-B Series 1 (Murine Monoclonal), Anti-B Series 3 (Murine Monoclonal) and Anti-A,B Series 1 (Murine Monoclonal Blend) are intended for use in slide, tube and microplate tests.

ABO, Anti-D
Immucor Anti-D Series 4 (Monoclonal Blend) is intended for use in slide, tube, microplate and automated tests. Immucor Anti-D Series 5 (Monoclonal Blend) is intended for use in slide, tube and microplate tests.

ABO, Anti-Human Globulin
Gamma-clone Anti-Human Globulin, Anti-IgG (Murine Monoclonal) Green or Uncolored is intended for use in direct or indirect antiglobulin tests where the detection of IgG is required.

ABO, Bovine Albumin Solution
In 1945, Cameron and Diamond established that certain anti-D (anti-Rho) sera would agglutinate Rh positive red cells suspended in albumin but would not agglutinate the same cells in a saline medium. Bovine albumin is used to enhance the reactivity of blood group antibodies.

ABO, Capture-R®
The Capture-R Select Solid Phase System provides modified microwells for the immobilization of human erythrocytes for use in solid phase assays for the detection of IgG red blood cell antibodies to corresponding red blood cell antigens (e.g. antibody screening, selected red blood cell panels, crossmatching, or antigen phenotyping).

ABO, Checkcell®
Checkcell and Checkcell (Weak) are used to confirm the validity of negative antiglobulin tests.

ABO, CorQC®
corQC Test System is used for the daily quality control evaluation of routine blood bank reagents.

ABO, Referencells®
Referencells (Pooled Cells) are intended for use in tube and microplate ABO serum grouping tests.

Procedure

ABO, Anti-A, Anti-B, and Anti-A,B
Direct agglutination of red blood cells with a particular reagent indicates the presence of the corresponding antigen. No agglutination generally indicates its absence (see LIMITATIONS). The ABO group of a red blood cell specimen is determined from the pattern of reactivity obtained with the reagents tested (see Interpretation of Results). Because the sera of most individuals older than 6 months of age consistently and predictably contain antibodies to the ABO antigen(s) they are lacking, serum grouping (reverse grouping) tests, employing reagent A1 and B red blood cells, are used to confirm results obtained in red blood cell grouping tests of individuals other than newborn infants. Discrepancies between red blood cell and serum grouping must be resolved before the blood group is recorded. The resolution of typing discrepancies is discussed in references 8 and 9. Package Insert

ABO, Anti-D
Agglutination of red blood cells at the immediate spin or 37 C incubated phases of testing with Anti-D indicates the presence of D antigen (see section on QUALITY CONTROL). No agglutination at these phases signifies either the absence of D, or that the red blood cells possess a weakened form of the D antigen. Negative reactions obtained at the antiglobulin phase of testing will confirm the absence of D. Package Insert D4  Package Insert D5

ABO, Anti-Human Globulin
Anti-Human Globulin reagents are employed in direct and indirect antiglobulin testing. The direct antiglobulin test is used to detect red blood cell sensitization with IgG and complement components (C3b and C3d) that have occurred in vivo. Washed red blood cells are tested directly with Anti-Human Globulin reagent. Indirect antiglobulin techniques are used to demonstrate in vivo sensitization of red blood cells with IgG and complement components. Serum or plasma containing antibody is first incubated with red blood cells to allow antigen-antibody binding to occur. The red blood cells are then washed and tested with Anti-Human Globulin reagent. Package Insert

ABO, Bovine Albumin Solution
The mechanism of action of bovine albumin was first investigated in 1964 by Pollack. From his experiments he concluded that agglutination of antibody-coated red cells depends on the dimensions of the antibody involved and characteristics of the reaction medium such as ionic strength. lgM blood group antibodies agglutinate red cells in isotonic saline but IgG molecules do not. Some lgG antibodies, especially those with Rh-hr specificities, will agglutinate red cells if the zeta potential, i.e., the effective electrical charge, is carefully adjusted by the addition of colloids and salts.

Stroup and Macllroy, in 1965, showed that albumin also enhances the sensitivity of the indirect antiglobulin test. This test is used to demonstrate antibodies that combine with, but do not agglutinate, red blood cells. The indirect antiglobulin test is used in compatibility testing, antibody screening, identification and titration. Serum and red cells are mixed in vitro to allow attachment of the antibody prior to testing the red cells as in the direct antiglobulin test. Package Insert

ABO, Capture-R®
Capture-R assays are based upon the procedure of Plapp et al.1 and Juji et al2. Red blood cells are first immobilized on the surface of polystyrene microwells. The antigens carried on the immobilized red blood cells are used to capture red blood cell-specific IgG antibodies. Following incubation, unbound residual immunoglobulins are rinsed from the wells and anti-IgG-coated indicator red cells are added. Centrifuation brings the indicator red cells in contact with antibodies bound to the immobilized red blood cell layers. In the case of a positive test, IgG-anti-IgG complexes form between the indicator red cells and the sensitized, immobilized red blood cells. As a consequence of antibody bridging, the indicator red cells adhere to the immobilized cells as a second immobilized layer. In the absence of detectable antigen-antibody interactions (negative test), the indicator red cells do not bind to the immobilized red blood cells and pellet to the bottom of the wells as tightly packed red blood cells buttons.

For selected red blood cell panels, reagent red blood cells are bound to the test wells and incubated with the patient's serum. The pattern of positive and negative results obtained at test completion is used to assist in the detection or identification of red blood cell antibody(ies) (i.e. supplement to Capture-R Ready-ID).

In crossmatch tests, donor red blood cells are bound to Capture-R Select test wells. The cells are then incubated in the presence of patient (recipient) serum or plasma. Positive tests indicate the recipient has produced antibodies to antigens present on the donor red blood cells. A negative test indicates the absence of detectable IgG antibody to donor antigens.

In antigen phenotyping tests, donor or patient red blood cells are bound to Capture-R Select test wells. The bound red blood cells are incubated with a selected antiserum and may be tested in parallel with an autologous control. Positive tests with the selected antiserum indicate the presence of the corresponding antigen if the autologous control is negative. A positive reaction with the autologous control indicates the absence of corresponding red blood cell antigen. Package Insert

ABO, Checkcells®
Negative antiglobulin results are valid only when active Anti-Human Globulin has been added to tubes containing sufficiently washed and unsensitized red blood cells. Falsely negative results will occur if the Anti-Human Globulin has been:

1. inactivated by residual serum globulins following improper (incomplete) washing of test red blood cells,

2. inactivated through reagent contamination prior to testing, or 

3. omitted from the test system.

Checkcell or Checkcell (Weak) is added to all negative antiglobulin tests. Anti-Human Globulin that does not agglutinate properly washed red blood cells in an antiglobulin test should remain in the active state and should be capable of agglutinating Checkcell or Checkcell (Weak). If Anti-Human Globulin has been omitted from the test system, or it has been inactivated, no agglutination of the Checkcell or Checkcell (Weak) reagent will occur. Teses in those tubes in which Checkcell or Checkcell (Weak) is negative much be repeated and the original results considered invalid. Package Insert

ABO CorQC®
Group AB, D+ red blood cells are used to prepare corQC Reagent Cells. They are used to evaluate the performance of Anti-A, Anti-B, Anti-A, B, Anti-D and Rh-Hr Control. corQC Reagent Antiserum contains weakly reactive monoclonal and polyclonal antibodies. It is used to evaluate serum (reverse) grouping red blood cells and antibody detection red blood cells. corQC Reagent Antiserum also assists in monitoring the performance of potentiators and Anti-Human Globulin (anti-IgG component). corQC Reagent Cells and corQC Reagent Antiserum should produce readily visible agglutination reactions with the reagents under test. No agglutination indicates reagent deterioration or technique failure. Package Insert

ABO, Referencells® (Pooled Cells)
The ABO system is the only blood group system where persons, older than 6 months of age, consistently and predictably produce antibodies to antigens that they lack. As a consequence, ABO grouping is performed with serum as well as red blood cells. Serum is systematically tested against Referencells reagent red cells. Agglutination of A1, A2 or B cells constitutes a positive test and is the result of a reaction between an antigen and its respectively antibody. No agglutination may indicate either the absence of antibody (providing the test red blood cells possess the corresponding antigen) or that an antibody, if present, is in concentrations too low to be detected by the serologic technique employed. The ABO group of a serum or plasma specimen should match that of the red blood cells. Agglutination of group O red blood cells shows the presence of a cold-reactive antibody other than anti-A and anti-B and indicates the reactions with A and B cells may not be due to anti-A or anti-B. Package Insert

Within 24 hours from receipt of specimen.

Specimen Type Order Code CPT Code NY Approved Volume Assay Range Special Instructions
Plasma 30832 86900/ 86901 Yes

2 mL (min 1 mL) 

Qualitative

  • Collect whole blood in an EDTA, lavender top tube. ACD Tube is also accepted. Do not freeze
  • If shipping in original EDTA vacutainer tube, ship ambient or refrigerated temperature, must be received within 10 days of collection.
  • If shipping in original ACD vacutainer tube, ship ambient or refrigerated temperature, must be received within 35 days of collection.
  • No neutral gel separator tubes.
Shipping

All specimens must be labeled with patient's name and collection date. A Viracor/VRL Eurofins Pre-Transplant test requisition form must accompany each specimen. Multiple tests can be run on one specimen. Ship specimens FedEx Priority Overnight® to: VRL Eurofins, 6933 S. Revere Parkway, Centennial, CO 80112.

Causes for Rejection

Whole blood frozen, specimens beyond their acceptable length of time from collection as listed in the specimen handling, or specimen types other than those listed.

Specimens are approved for testing in New York only when indicated in the Specimen Information field above. The CPT codes provided are based on VRL Eurofins' interpretation of the American Medical Association's Current Procedural Terminology (CPT) codes and are provided for informational purposes only. CPT coding is the sole responsibility of the billing party. Questions regarding coding should be addressed to your local Medicare carrier. VRL Eurofins assumes no responsibility for billing errors due to reliance on the CPT codes illustrated in this material.

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