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Automation in imunohematology
DOMINOVÁ, Alena
Nowadays automation in immunohematologic testing is becoming part of routine methods used in transfusion laboratories.It also has got considerable importance for pretransfusion testing of patients and for immunohematologic testing of blood donors.Immunohematology was the last among all medical laboratories into which automation was introduced.The use of robust techniques made it possible.These techniques are column agglutination carried out on gel or on glass microballs and solid phase technique.The latest method is Erytrocytes Magnetizer technology and it is not so widespread yet.The aim of this thesis is practical performance of immunohematologic methods blood group,antibody screening.Tube testing,testing on microtiter plates and using column agglutination.Manual performance was compared with Qasar and Techno analyzers.Other aims were quantitative description of reagent saving,human labor force and to assess other effects which are more sensitive methods,greater safety and exclusion of possible mistake during the automated testing process.The theoretical part deals with particular tests and their possible performance techniques.Automation contributes to minimize possible risks.Automation reduces process steps,the need for worker intervention and exponentially decreases the number of potential mistakes.Introduction of automation also helps to standardize procedures and reagents to increase reliability,result interpretation and results of the tested process.On top of that automation is useful for generation of reliable results,their objective interpretation,better documentation,monitoring and traceability and labour force saving.It brings security not only to patients but also to medical workers.Inseparable necessities are space conditions and device service.The practical part of this thesis was performed in the Blood Bank Department of Hospital České Budějovice.Samples examined in this thesis included 24patient samples,24blood donor samples and 2samples for inner quality control.In all 50samples blood group was tested manually in test tubes and on microtiter plates.Antigen screening was tested in test tubes,on microtiter plates and using column agglutination.Patient samples were analysed using Techno analyser and blood donor samples were analysed using semiautomatic machine Qasar.10slightly positive screenings of patient antigens(previously tested using Techno analyser)and 10positive screenings of blood donor antigens(previously tested using semiautomatic machine Qasar)were manually tested again in test tubes and on microtiter plates during 2013.It was found out that both manual and automatic testing give same results.Only in manual testing of antibody screening in test tube the reaction in both positive testing Basic QC,was a bit smaller which is caused by lower sensitivity of the test tube method.In antibody screening the quantitative saving of reagents in column agglutination is bigger when tested both manually and with the use of both analysers than when tested in test tube.Concerning the difficulty,longwindedness and especially lower sensitivity of tube testing,the decision not to use this method was a correct choice.This comparison confirms assessments described above and also the correctness of decision to use column agglutination for antibody screening tests.Different time consumption of testing of particular samples gave possibility for simple quantitative calculation of human labour force saving.It gave clear result saving of 2human labour forces thanks to each analyser.Individual steps during testing are shown in table and the chance of bringing the possibility of a mistake.Manual testing includes possibility of making a mistake in all mentioned critical moments of testing.Automatized only once using semiautomatic machine Qasar,where there is a possibility of mistaken exchange during preparation of reagents.Reagents do not have bar codes.Techno analyser succeeded in all critical steps without a mistake.
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