Enhancing Red Blood Cell Antigen Testing Efficiency Through Automation Utilizing In-House Quality Control

Document Type

Conference Proceeding

Publication Date

10-1-2025

Publication Title

Transfusion

Abstract

Background/Case Studies: A large academic and research hospital serves as the central distribution hub for red blood cell (RBC) units across its healthcare network. Ensuring timely access to antigen-negative blood is essential for patients with alloantibodies or those requiring chronic transfusions. Traditionally, this process involved requesting specific units from donor centers or manually screening in-house inventory-both timeconsuming and labor-intensive methods that delayed care and strained technologist resources. Study Design/Methods: To improve efficiency, the hospital implemented extended phenotype testing using an automated immunohematology analyzer (Werfen, Norcross, GA), capable of detecting a broad panel of RBC antigens (C, c, E, e, K, Fya, Fyb, Jka Jkb). However, commercially available quality control (QC) materials only cover a limited subset of these antigens. To address this, an in-house QC protocol was developed. Approximately 20 Group O RBC units were manually tested initially to identify donor units that were either negative or heterozygous positive for the desired antigens. Segments from these units were collected and used as QC samples, which were then incorporated into the daily automated testing workflow. With each run of the extended phenotype assays, additional QC samples were easily identified for future use. Figure 1 outlines the QC and testing process. Results/Findings: This approach enabled comprehensive antigen testing across the full assay panel and ensured consistent quality assurance. The in-house QC protocol standardized testing procedures, reduced variability, and saved approximately 2 h of technologist time per run. When unexpected antibodies were identified in patients, compatible unit selection became significantly faster, saving an additional 20-40 min per occurrence. Conclusions: The implementation allowed technologists to focus on more complex, value-added tasks and reduced turnaround time (TAT) for antigen typing. Although formal time studies were not conducted, observed efficiency gains improved sample processing speed-critical in clinical settings. Future plans include expanding testing to Group A units to reduce Group O usage and this model, combining automation with in-house QC, expanded testing capabilities, improved TAT, and optimized workflow. It offers a scalable, practical solution for institutions seeking to enhance transfusion services.

Volume

65

Issue

S2

First Page

294A

Last Page

295A

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