Comparison of the tube test and column agglutination techniques for anti-A/-B antibody titration in healthy individuals

Vox Sang. 2018 Nov;113(8):787-794. doi: 10.1111/vox.12713. Epub 2018 Sep 24.

Abstract

Background and objectives: Determination of the anti-A/-B titre pre- and post-transplantation is beneficial for treatment selection. Currently, the recommended method for antibody titration is the tube test (TT) assay. Dithiothreitol (DTT) is used for IgM antibody inactivation. Recently, a fully automated antibody titration assay using the column agglutination technique (CAT) was developed (auto-CAT). Our aim was to compare the auto-CAT and TT techniques for ABO antibody titration, to evaluate the effectiveness of DTT-treated plasma for use with auto-CAT and to define the cut-off value for antibody titration by auto-CAT.

Materials and methods: We enrolled 30 healthy individuals, including 10 each for blood types A, B and O. We performed antibody titre measurement using the TT technique and auto-CAT simultaneously. Auto-CAT uses the bead column agglutination technology.

Results: With the auto-CAT cut-off value set to weak (w)+ with DTT treatment plasma, the concordance rate was 45%, and the weighted kappa value between TT and auto-CAT results was 0·994 in all subjects. Furthermore, there was a significant positive correlation between the anti-A/-B titre results obtained using the TT technique and auto-CAT in all blood types. Moreover, a positive bias (falsely elevated end-points due to agglomeration of A/B cells) was not observed in auto-CAT testing using DTT-treated plasma.

Conclusion: Our results show that 1+ agglutination using the TT technique is equivalent to w+ agglutination obtained using auto-CAT. We recommend that DTT may be used with auto-CAT to measure antibody titres. Thus, we suggest that auto-CAT is useful for antibody titration in routine examination.

Keywords: antibody titration; column agglutination technique; pretransplantation; tube test technique.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Agglutination Tests / methods*
  • Agglutination Tests / standards
  • Blood Group Antigens / blood
  • Blood Group Antigens / immunology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Sensitivity and Specificity

Substances

  • Blood Group Antigens