Comparative analysis of of High- and Low-Titre Anti-A/B Testing in Blood Donors: Automated IgM vs Manual IgM, IgM vs IgG, and Demographic Influences"

Abstract

Background: Testing high-titre anti-A and anti-B antibodies is a fundamental aspect of transfusion medicine, as these antibodies are critical in assessing the safety and compatibility of blood transfusions, particularly in cases of ABO incompatibility. Accurate determination of antibody strength is essential to minimize the risk of hemolytic transfusion reactions. Although both manual and automated testing methodologies are available, their comparative effectiveness in reliably detecting high-titre ABO antibodies remains inadequately explored. Objective: The purpose of the current study is to compare the efficacy of manual and automated methods for testing IgM ABO antibodies in high and low titre populations. Furthermore, evaluation of the need for IgG antibodies besides IgM, and comparative analysis based on different demographic factors such as age and gender were also evaluated. Methodology: The research involved randomly selecting 25 high-titre positive donors and 25 high-titre negative donors from NHSBT. These samples were previously analysed with automatic analyser PK7400. Plasma was extracted from selected blood samples and analysed using the column agglutination method to identify IgG and IgM antibody levels. A1rr and Brr cells were used to identify anti-A and anti-B antibodies, respectively. These results were compared with automatic testing results that measure IgM antibody only. Furthermore, comparative analysis of IgG and IgM antibodies, age and gender differences were performed in high and low titre populations. Results: Comparative analysis of manual and automatic testing revealed that automatic methods overestimated IgM levels. The findings revealed significant variability in antibody titres among different blood groups, with blood group O exhibiting the highest IgG and IgM levels. Age and gender also play a crucial role, with younger individuals showing the highest antibody levels and females generally having higher antibody titres compared to males. Conclusion: The comparison between manual and automated methods indicates that while automated techniques offer efficiency and consistency, manual methods may provide more sensitivity in detecting antibody titres at lower levels. The study highlights the need for IgG testing along with IgM testing. These insights are valuable for optimizing blood transfusion safety and understanding immune response variability among blood donors.