title: Antenatal monitoring of anti-D and anti-c: could titre scores determined by column agglutination technology replace continuous flow analyser quantification?
abstract: OBJECTIVE
  To determine if column agglutination technology (CAT) for titration of anti-D and anti-c concentrations produces comparable results to those obtained by continuous flow analyser (CFA).
  
  
  BACKGROUND
  Anti-D and anti-c are the two commonest antibodies that contribute to serious haemolytic disease of the foetus and neonate (HDFN). Current practice in the UK is to monitor these antibodies by CFA quantification, which is considered more reproducible and less subjective than manual titration by tube IAT (indirect antiglobulin test). CAT is widely used in transfusion laboratory practice and provides a more objective endpoint than tube technique.
  
  
  METHODS
  Antenatal samples were (i) quantified using CFA and (ii) titrated using CAT with the reaction strength recorded by a card reader and expressed as a titre score (TS).
  
  
  RESULTS
  The TS rose in accordance with levels measured by quantification and was able to distinguish antibody levels above and below the threshold of clinical significance.
  
  
  CONCLUSIONS
  CAT titre scores provided a simple and reproducible method to monitor anti-D and anti-c levels. The method was sensitive to a wide range of antibody levels as determined by quantification. This technique may have the potential to replace CFA quantification by identifying those cases that require closer monitoring for potential HDFN.
authors: Red Cell Immunohaematology Department.
authors: D G
authors: DG
authors: Bruce
authors: NHS Blood and Transplant (NHSBT), Newcastle Upon Tyne, UK.
authors: H N
authors: HN
authors: Tinegate
authors: Red Cell Immunohaematology, NHSBT, Leeds, UK.
authors: M
authors: M
authors: Williams
authors: Red Cell Immunohaematology Department.
authors: R
authors: R
authors: Babb
authors: NHS Blood and Transplant (NHSBT), Newcastle Upon Tyne, UK.
authors: A W
authors: AW
authors: Wells
mesh_terms: D000328:Adult; D000372:Agglutination Tests / Q000295:instrumentation* / Q000379:methods; D001331:Automation; D003298:Coombs Test; D004899:Erythroblastosis, Fetal / Q000517:prevention & control; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007518:Isoantibodies / Q000097:blood*; D010865:Pilot Projects; D011247:Pregnancy; D011295:Prenatal Care / Q000379:methods*; D015203:Reproducibility of Results; D018029:Rho(D) Immune Globulin
chemical_list: D007518:Isoantibodies; C061961:RHO(D) antibody; D018029:Rho(D) Immune Globulin; C051138:anti-c antibody