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Factors Affecting Hemagglutinations Strength in ABO Blood Group Typing Test Using the Tube Method
J Lab Med Qual Assur 2018;40:161-170
Published online September 30, 2018
© 2018 Korean Association of External Quality Assessment Service.

You La Jeon1, Woo-In Lee1,2, So Young Kang1,2, and Myeong Hee Kim1,2

1Department of Laboratory Medicine, Kyung Hee University Hospital at Gangdong; 2Department of Laboratory Medicine, Kyung Hee University School of Medicine, Seoul, Korea
Correspondence to: Woo-In Lee
Department of Laboratory Medicine, Kyung Hee University Hospital at Gangdong, 892 Dongnam-ro, Gangdong-gu, Seoul 05278, Korea
Tel: +82-2-440-7190
Fax: +82-2-440-7195
Received June 28, 2018; Revised August 15, 2018; Accepted August 20, 2018.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Background: The ABO blood group typing test (ABO test) is an initial pre-transfusion test based on hemagglutination. Although various factors affect hemagglutination strength, few studies have examined how these factors can be applied in clinical laboratories and their effects on hemagglutination. This study was conducted to analyze the factors affecting hemagglutination strength in the ABO test using a tube method applied in many laboratories.
Methods: We conducted a detailed questionnaire survey of 51 laboratories which use the ABO test with a tube method. We also analyzed the results of the ABO test (cell and serum typing) with 40 specimens using factors affecting hemagglutination at a tube method and applied differently in each laboratory.
Results: Each laboratory used various methods to prepare red cell suspensions as specimens or reagents and used different reagent to sample ratios, centrifugation protocols, and shaking test tubes before evaluating hemagglutination strength. By testing various combinations of these factors, direct sampling from the red cell layer of the original specimen was found to have the largest effect on lowering hemagglutination strength in cell typing tests. In serum typing tests, various factors influenced hemagglutination strength, including shaking the tube before analysis and the concentration of a home-made red cell suspension used as a reagent.
Conclusions: To achieve accurate results in the ABO test by the tube method, detailed guidelines that include the factors affecting hemagglutination strength determined in this study should be established.
Keywords : Blood group typing test, Hemagglutination strength, Tube method, Red cell suspension
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