- 期刊
臨床實驗室Antibody Titration Test標準化作業之調查
Survey of Standardization Antibody Titration Test in ClinicalLaboratory
摘要
血清中ABO血型抗體的力價，對於臨床上監控ABO血型不配合的器官移植或血小板輸血無效，是相當重要的檢驗。因此本研究的目的主要是探討不同實驗方法與判讀標準對於ABO抗體力價結果的差異。利用30名O型血小板分離術捐血者血漿檢體，以saline_indirect antiglobulin test（Saline_IAT）和column agglutination test（CAT），分別測定Anti-A與Anti-B抗體力價。結果顯示，在Saline_IAT方法中不同的判讀標準會使抗體力價明顯相差1～2個級數，而Saline_IAT與CAT兩種不同方法之一致性約45%；此外不同操作人員之結果也存在30－40%之不一致性。因此實驗室應將antibody titration的檢體處理、儀器設備使用、操作步驟、結果判讀制訂標準化流程，並定期執行人員一致性訓練，才能減少抗體力價報告的差異性，使得抗體力價的測定報告更具一致性，並有效提供正確數據供臨床應用。
關鍵字
無資料並列摘要
ABO antibody titration is important for monitoring ABO-incompatible organ transplants and preventing platelet refractory due to ABO-incompatibility. The primary goal of this study was to investigate the variation between different testing techniques and the interpretation standards regarding the ABO antibody titers. Thirty plasma specimens separated from Group O apheresis platelet concentrates were collected for Anti-A and anti-B titration using saline indirect antiglobulin test (Saline IAT) and column agglutination test (CAT). With saline IAT method, an 1 to 2 scale variation occurred between different interpretation standards (1+end-point versus w+end-point), and there were a low consistency of ABO antibody titration of only 45% between Saline IAT and CAT methods. In addition, 30-40% of discordant results were obtained between two different operators. In conclusion, the laboratory should standardize the assay procedure and interpretation method in ABO antibody titration. A detailed SOP of the standardized method for ABO titration with periodic consistency practice between operators should be implemented within the laboratory to reduce testing variability and to ensure an efficient antibody titration testing for clinical application.