BACKGROUND: The measurement of anti-blood groups A and B antibody (Ab) titers is considered to be important in ABO-incompatible transplantation. However, no standard method for quantitative determination has yet been established in Japan. Inter-examiner variability was likely because Ab titer was determined mainly by visual observation. In order to assess inter-institutional variation in the measurement of anti-A/B Ab titer, a series of surveys was conducted by the Japanese ABO-incompatible Transplantation Committee. METHODS AND RESULTS: In 2003, the first national survey was conducted. Serum samples from six healthy volunteers with blood groups A (n = 2), B (n = 2) and O (n = 2) were sent to 29 institutions and anti-A/B Ab titer was measured by their customary methods. Isohemagglutinin assay in serial-doubling dilutions of serum using a test tube was widely used in all institutions. Inter-institutional difference between maximum and minimum value reached as much as 32-fold in immunoglobulin M (IgM) and 256-fold in IgG. As detailed protocol for assay seemed to be different between institutions, we attempted to standardize the protocol based on the result of a questionnaire survey. In 2004, a second survey was conducted in the same manner as the previous one, except participation involved 38 institutions and the measurement was performed in a uniform way using a provisional standard protocol. Analysis of the survey revealed that intra-institutional variation was reduced to below eightfold, except that several institutions showed a large difference from the mean titer and required some guidance. CONCLUSIONS: A periodical quality control survey is considered necessary to improve the accuracy of measurement. Anti-A/B Ab titer would provide useful information towards the prediction of rejection and the indication of treatments such as (double filtration) plasmapheresis, splenectomy, anti-CD20 monoclonal antibody and intravenous immunoglobulin. Standardization of the assay for anti-A/B Ab titer is essential for the fulfillment of a precise multicenter study, which will elucidate the significance of the measurement of anti-A/B Ab titer.
BACKGROUND: The measurement of anti-blood groups A and B antibody (Ab) titers is considered to be important in ABO-incompatible transplantation. However, no standard method for quantitative determination has yet been established in Japan. Inter-examiner variability was likely because Ab titer was determined mainly by visual observation. In order to assess inter-institutional variation in the measurement of anti-A/B Ab titer, a series of surveys was conducted by the Japanese ABO-incompatible Transplantation Committee. METHODS AND RESULTS: In 2003, the first national survey was conducted. Serum samples from six healthy volunteers with blood groups A (n = 2), B (n = 2) and O (n = 2) were sent to 29 institutions and anti-A/B Ab titer was measured by their customary methods. Isohemagglutinin assay in serial-doubling dilutions of serum using a test tube was widely used in all institutions. Inter-institutional difference between maximum and minimum value reached as much as 32-fold in immunoglobulin M (IgM) and 256-fold in IgG. As detailed protocol for assay seemed to be different between institutions, we attempted to standardize the protocol based on the result of a questionnaire survey. In 2004, a second survey was conducted in the same manner as the previous one, except participation involved 38 institutions and the measurement was performed in a uniform way using a provisional standard protocol. Analysis of the survey revealed that intra-institutional variation was reduced to below eightfold, except that several institutions showed a large difference from the mean titer and required some guidance. CONCLUSIONS: A periodical quality control survey is considered necessary to improve the accuracy of measurement. Anti-A/B Ab titer would provide useful information towards the prediction of rejection and the indication of treatments such as (double filtration) plasmapheresis, splenectomy, anti-CD20 monoclonal antibody and intravenous immunoglobulin. Standardization of the assay for anti-A/B Ab titer is essential for the fulfillment of a precise multicenter study, which will elucidate the significance of the measurement of anti-A/B Ab titer.
Authors: Jeong Kye Hwang; Sang Il Kim; Bum Soon Choi; Cheol Woo Yang; Yong Soo Kim; In Sung Moon; Ji Il Kim Journal: J Korean Surg Soc Date: 2011-07-11
Authors: Eun Su Park; Kyung Il Jo; Jeong Won Shin; Rojin Park; Tae Yoon Choi; Hae In Bang; Gum Ran Chai; Soon Gyu Yun Journal: Ann Lab Med Date: 2014-04-08 Impact factor: 3.464
Authors: P N Gupta; S Pokhariyal; S Bansal; S Jain; V Saxena; R Sharma; M Jain; P Jha; S K Sethi; P Ghosh; A Tewari; R Ahlawat; V Kher Journal: Indian J Nephrol Date: 2013-05