Skip to main content
Journal of Clinical Laboratory Analysis logoLink to Journal of Clinical Laboratory Analysis
. 2004 Sep 3;18(5):255–258. doi: 10.1002/jcla.20033

Comparison of conventional tube test technique and gel microcolumn assay for direct antiglobulin test: A large study

MCZ Novaretti 1,2,, E Jens 2, T Pagliarini 2, SL Bonifacio 2, PE Dorlhiac‐Llacer 1,2, DAF Chamone 1,2
PMCID: PMC6807709  PMID: 15356874

Abstract

Gel microcolumn assay (GMA) is a modified serological technique that has been used for ABO and Rh typing, direct antiglobulin test (DAT), detecting alloantibodies, red cell phenotyping, and other applications. However, for DAT, the role of GMA is controversial. The purpose of this large study was to compare the performance of the conventional tube test (CTT) to GMA for detecting potentially significant antibodies coating red blood cells in vivo. From January 1996 to May 2002, we performed DATs by GMA and CTT on 9,862 blood samples submitted to our reference laboratory, using LISS/Coombs cards (DiaMed‐Latino America, Lagoa Santa‐MG, Brazil) for GMA and polyspecific and monospecific anti‐IgG reagents for CTT. Acid eluates were prepared from all positive DAT samples. The specificity of eluates was determined by GMA. We detected nonconcordant results in 2,079 out of 3,163 positive DATs (65.7%). All of these tests were only positive in GMA. Sensitivity and specificity for DATs was 100% and 83.0% for gel, and 50.7% and 97.8% for tube, respectively. Based on this study GMA showed to be more sensitive than CTT for detecting potentially significant antibodies coating red blood cells in vivo. J. Clin. Lab. Anal. 18:255–258, 2004. © 2004 Wiley‐Liss, Inc.

Keywords: direct antiglobulin test, conventional tube test, gel microcolumn assay, gel test, alloantibodies, elution, clinically significant antibodies

REFERENCES

  • 1. Moreschi C. Neue tatsachen über die blutkörperchen‐agglutination. Zbl Bakt 1908;46:49–51. [Google Scholar]
  • 2. Coombs RRA, Mourant AE, Race RR. Detection of weak and ‘incomplete’ Rh agglutinins: A new test. Lancet 1945;ii:15–16. [PMC free article] [PubMed] [Google Scholar]
  • 3. Coombs RRA, Mourant AE, Race RR. A new test for the detection of weak and ‘incomplete’ Rh agglutinins. Br J Exp Pathol 1945;26:255–266. [PMC free article] [PubMed] [Google Scholar]
  • 4. Coombs RRA. Historical note: past, present and future of the antiglobulin test. Vox Sang 1998;74:67–73. [PubMed] [Google Scholar]
  • 5. Brecher M, editor. Technical manual AABB, 14th ed Bethesda: American Association of Blood Banks; 2002. pp. 497, 667. [Google Scholar]
  • 6. Win N, Islam SIAM, Peterkin MA, Walker ID. Positive DAT due to antiphospholipid antibodies in normal healthy blood donors. Vox Sang 1997;72:182–184. [DOI] [PubMed] [Google Scholar]
  • 7. Heddle N, Kelton JG, Turchyn KL, Ali MAM. Hypergammaglobulinemia can be associated with a positive DAT, a nonreactive eluate, and no evidence of hemolysis. Transfusion 1988;28:29–33. [DOI] [PubMed] [Google Scholar]
  • 8. Petz LD. Drug‐induced autoimmune hemolytic anemia. Transfus Med Rev 1993;7:242–254. [DOI] [PubMed] [Google Scholar]
  • 9. Nathalang O, Chuasumrit A, Prayoonwiwat W, Siripoonya P, Sriphaisal T. Comparison between the conventional tube technique and the gel technique in DATs. Vox Sang 1997;72:169–171. [DOI] [PubMed] [Google Scholar]
  • 10. Reis KJ, Chachowski R, Cupido A, Davies D, Jakway J, Setcavage TM. Column agglutination technology: the antiglobulin test. Transfusion 1993;33:639–643. [DOI] [PubMed] [Google Scholar]
  • 11. Issitt PD, Anstee DJ, editors. Applied Blood Group Serology, 4 th ed Durban: Montgomery Scientific Publications; 1998. p 948. [Google Scholar]
  • 12. Lapierre Y, Rigal D, Adam J, et al. The gel test: a new way to detect red cell antigen‐antibody reactions. Transfusion 1990;30:109–113. [DOI] [PubMed] [Google Scholar]
  • 13. Novaretti MCZ, Dulley FL, Dorlhiac‐Llacer PE, Chamone DAF. Use of the gel test to detect mixed red blood cell populations in bone marrow transplantation patients. Vox Sang 1993;65:161–162. [DOI] [PubMed] [Google Scholar]
  • 14. Bromilow IM, Eggington JA, Owen GA, Duguid JK. Red cell antibody screening and identification: a comparison of two column technology methods. Br J Biomed Sci 1993;50:329–333. [PubMed] [Google Scholar]
  • 15. Novaretti MZ, Jens Silveira E, Filho EC, Dorlhiac‐Llacer PE, Chamone DAF. Comparison of tube and gel techniques for antibody identification. Immunohematology 2000;16:138–141. [PubMed] [Google Scholar]
  • 16. Tissot JD, Kiener C, Burnand B, Schneider P. The DAT: still a place for the tube technique?. Vox Sang 1999;77:223–226. [DOI] [PubMed] [Google Scholar]
  • 17. Judd WJ, Steiner EA, Knafl PC, Masters C. The gel test: use in the identification of unexpected antibodies to blood group antigens. Immunohematology 1998;14:59–62. [PubMed] [Google Scholar]
  • 18. Daniels G, Poole J, de Silva, Callaghan T, Mac Lennan S, Smith N. The clinical significance of blood group antibodies. Transfus Med 2002;12:287–295. [DOI] [PubMed] [Google Scholar]
  • 19. Huh YO, Lichtiger B. Evaluation of a positive autologous control in pretransfusion testing. Am J Clin Pathol 1985;84:632–636. [DOI] [PubMed] [Google Scholar]
  • 20. Freedman J. False‐positive antiglobulin tests in healthy subjects and in hospital patients. J Clin Pathol 1979;32:1014–1018. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 21. Dittmar K, Procter JL, Cipolone K, Njoroje JM, Miller J, Stroncek DF. Comparison of DATs using traditional tube agglutination to gel column and affinity column procedures. Transfusion 2001;41:1258–1262. [DOI] [PubMed] [Google Scholar]
  • 22. Fabijanska‐Mitek J, Namirska‐Krzton H, Seyfried H. The value of gel test and ELAT in autoimmune haemolytic anaemia. Clin Lab Haematol 1995;17:311–316. [PubMed] [Google Scholar]
  • 23. Novaretti MCZ, Sopeleti CR, Dorlhiac‐Llacer PE, Chamone DAF. Evaluation of gel‐test technology in drug induced positive DATs. Transfusion 2000;40(suppl):10S,114S. [Google Scholar]
  • 24. Gorst DW, Raweison VI, Merry AH, Stratton F. Positive DAT in normal individuals. Vox Sang 1980;38:99–105. [DOI] [PubMed] [Google Scholar]
  • 25. Leger RM, Arndt PA, Ciesielski DJ, Garraty G. False‐positive reactivity due to the low‐ionic wash solution used with commercial acid‐elution kits. Transfusion 1998;38:565–572. [DOI] [PubMed] [Google Scholar]
  • 26. Judd WJ, Steiner EA, Knafl PC. The gel test: sensitivity and specificity for unexpected antibodies to blood group antigens. Immunohematology 1997;13:132–135. [PubMed] [Google Scholar]

Articles from Journal of Clinical Laboratory Analysis are provided here courtesy of Wiley

RESOURCES