Asian Journal of Transfusion Science

ILLUSTRATION
Year
: 2017  |  Volume : 11  |  Issue : 2  |  Page : 77--78

A handy chart for the interpretation of sequential differential adsorption–elution procedure


Shamee Shastry, Soumya Das 
 Department of Immunohematology and Blood Transfusion, Kasturba Medical College, Manipal University, Manipal, Karnataka, India

Correspondence Address:
Shamee Shastry
Department of Immunohematology and Blood Transfusion, Kasturba Medical College, Manipal University, Manipal, Karnataka
India




How to cite this article:
Shastry S, Das S. A handy chart for the interpretation of sequential differential adsorption–elution procedure.Asian J Transfus Sci 2017;11:77-78


How to cite this URL:
Shastry S, Das S. A handy chart for the interpretation of sequential differential adsorption–elution procedure. Asian J Transfus Sci [serial online] 2017 [cited 2021 Sep 21 ];11:77-78
Available from: https://www.ajts.org/text.asp?2017/11/2/77/214338


Full Text

Differential adsorption and elution procedures are often helpful in separating multiple antibodies in a complex mixture. One of the applications of this procedure is to confirm the presence or absence of anti-D, anti-C, and anti-G in the serum with apparent anti-D + anti-C specificities in alloimmunized pregnancies.[1] We performed a modified sequential differential adsorption-elution procedure in such patients. Unlike the method described in the literature, to begin with, we used enzyme-treated red blood cells of DEc phenotype for the adsorption, and the procedure (with the cell to serum ratio of 1:1) was repeated twice to achieve the complete adsorption of the antibody in the serum. The eluate obtained by cold acid elution technique from these cells was used for the second adsorption procedure with dCe cells. Following each step, the adsorbed serum and the eluate were tested against the D+C- and D-C + screening cells. We validated this procedure using the known mixture of antibodies and the samples from five antenatal cases. Baia et al. have explained a simple approach to confirm the presence of anti-D in sera with the presumed anti-D and anti-C specificity.[2] However, it requires two aliquots of serum to rule out all the five possible combinations: anti-D + anti-C, anti-G, anti-C + anti-G, anti-D + anti-G, and anti-D + anti-C + anti-G. We used only one aliquot (1.5 mL) of serum, and the total turnaround time was 6 h in the protocol mentioned above.

While performing this exercise, we realized that the interpretation of the final results of differential adsorption and elution test is quite challenging and time-consuming. Hence, we derived a handy chart which will help the immunohematologists to interpret the results of the above procedure easily [Table 1]. The chart was validated for the clarity and correctness by circulating it among six immunohematology experts.{Table 1}

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

1Shirey RS, Mirabella DC, Lumadue JA, Ness PM. Differentiation of anti-D, -C, and -G: Clinical relevance in alloimmunized pregnancies. Transfusion 1997;37:493-6.
2Baía F, Muñiz-Diaz E, Boto N, Salgado M, Montero R, Ventura T, et al. A simple approach to confirm the presence of anti-D in sera with presumed anti-D + C specificity. Blood Transfus 2013;11:449-51.