title: Comparative Analysis of Clinical Samples Showing Weak Serum Reaction on AutoVue System Causing ABO Blood Typing Discrepancies.
abstract: BACKGROUND
  ABO blood typing in pre-transfusion testing is a major component of the high workload in blood banks that therefore requires automation. We often experienced discrepant results from an automated system, especially weak serum reactions. We evaluated the discrepant results by the reference manual method to confirm ABO blood typing.
  
  
  METHODS
  In total, 13,113 blood samples were tested with the AutoVue system; all samples were run in parallel with the reference manual method according to the laboratory protocol.
  
  
  RESULTS
  The AutoVue system confirmed ABO blood typing of 12,816 samples (97.7%), and these results were concordant with those of the manual method. The remaining 297 samples (2.3%) showed discrepant results in the AutoVue system and were confirmed by the manual method. The discrepant results involved weak serum reactions (<2+ reaction grade), extra serum reactions, samples from patients who had received stem cell transplants, ABO subgroups, and specific system error messages. Among the 98 samples showing ≤1+ reaction grade in the AutoVue system, 70 samples (71.4%) showed a normal serum reaction (≥2+ reaction grade) with the manual method, and 28 samples (28.6%) showed weak serum reaction in both methods.
  
  
  CONCLUSIONS
  ABO blood tying of 97.7% samples could be confirmed by the AutoVue system and a small proportion (2.3%) needed to be re-evaluated by the manual method. Samples with a 2+ reaction grade in serum typing do not need to be evaluated manually, while those with ≤1+ reaction grade do.
authors.affiliation: Department of Laboratory Medicine, School of Medicine, Pusan National University, Medical Research Institute, Pusan National University Yangsan Hospital, Yangsan, Korea.
authors.forename: Su Yeon
authors.initials: SY
authors.lastname: Jo
authors.affiliation: Department of Laboratory Medicine, School of Medicine, Pusan National University, Medical Research Institute, Pusan National University Yangsan Hospital, Yangsan, Korea.
authors.forename: Ju Mi
authors.initials: JM
authors.lastname: Lee
authors.affiliation: Department of Laboratory Medicine, School of Medicine, Pusan National University, Medical Research Institute, Pusan National University Hospital, Busan, Korea.
authors.forename: Hye Lim
authors.initials: HL
authors.lastname: Kim
authors.affiliation: Department of Laboratory Medicine, School of Medicine, Pusan National University, Medical Research Institute, Pusan National University Hospital, Busan, Korea.
authors.forename: Kyeong Hwa
authors.initials: KH
authors.lastname: Sin
authors.affiliation: Department of Laboratory Medicine, School of Medicine, Pusan National University, Medical Research Institute, Pusan National University Yangsan Hospital, Yangsan, Korea.
authors.forename: Hyeon Ji
authors.initials: HJ
authors.lastname: Lee
authors.affiliation: Department of Laboratory Medicine, School of Medicine, Pusan National University, Medical Research Institute, Pusan National University Yangsan Hospital, Yangsan, Korea.
authors.forename: Chulhun Ludgerus
authors.initials: CL
authors.lastname: Chang
authors.affiliation: Department of Laboratory Medicine, School of Medicine, Pusan National University, Medical Research Institute, Pusan National University Hospital, Busan, Korea. hhkim@pusan.ac.kr.
authors.forename: Hyung Hoi
authors.initials: HH
authors.lastname: Kim
mesh_terms: D000017:ABO Blood-Group System / Q000097:blood*; D001331:Automation; D001771:Blood Banks; D001788:Blood Grouping and Crossmatching / Q000295:instrumentation / Q000379:methods*; D006801:Humans
chemical_list: D000017:ABO Blood-Group System
keywords: ABO typing; AutoVue system; Automated system; Discrepancy; Manual method