The Many Utilities of an In-house Red Cell Panel for Routine Workup in the Lab. How This Tool Improved Uruguay’s Central Hospital of the Armed Forces Immunohematology Service
Year: 2026
Type: article
Abstract: Introduction Our transfusion medicine department serves a population of more than 100,000 persons that include the members of the Armed Forces, as well as their relatives. With the foundation of a second-tier immunohematology laboratory, we handle routine antibody identification, as well as complex cases, like patients with autoimmune hemolytic anemia (AIHA), or antibodies against high frequency antigens. We still do not provide third-tier tools, such as genotyping. Since 2025, with the implementation of a massive donor phenotyping program, we prepared our lab for the incorporation of an in-house (IH) red cell panel to expand the available routine serologic techniques. Here we briefly describe the IH panel and how it transformed the quality of the services our lab provides. Aim To describe the utilities that the implementation of an in-house red cell panel brought to the immunohematology lab. Materials and methods We define an IH red cell panel not only as the reagent cells prepared from our blood donors, but also the blood bag units that give support to it and provide us access to an endless supply of these cells. Starting in February 2026, we have had 3 IH panels, ranging from 3 to 6 cells. Donors are type O. The first 3 cells are always R1R1, R2R2 and rr, with complete antigen complementary for Kell, MNS, Kidd and Duffy major antigens. rr K+ cells are a priority. We include 1 Dia+ cell. Typically, we spend a week assemblying each panel; we use a current database of 950 R1R1 (9 Dia+), 120 R2R2 (3 Dia +) and 500 rr (16 K+, 9 Dia+, 2 K+ Dia+) blood donors. Reagent cells are prepared for standard tube and gel techniques, and we also prepare enzyme-treated cell bottles. Each panel has a two-month shelf life. Results 1) Routine antibody screening: the IH panel presents excellent reaction scores, compared to commercial panels. In its editions, we have not missed the detection of a single antibody, while at the same time avoiding the interference of spurious reactivities. Many examples have been found of “evanescent” common antibodies in commercial panels that were detected with the IH panel. 2) Adsortion techniques: with an endless supply of fresh cells, our lab is ready to provide any adsortion analysis, whether for cases of AIHA or other complex cases. 3) Rare donors: autoctonous donors represent with high fidelity the antigen circulation in our population, something the commercial panels do not. As such, all the editions of our IH panels have presented cells with low frequency antigens (or lack of high frequency antigens) that are not present in commercial panels. These cells can then serve for screening and detection of additional rare antibodies and rare antigens. 4) Research: any serologic research project would need a constant supply of cell reagents for analysis. Our IH panel provides us the ability to conduct this type of research and, with the use of one common tool, allows us inter-laboratory cooperation. 5) Quality control (QC): due to its excellent reactivity scores, the IH panel has served us as a good QC tool, whether for commercial sera or polyclonal human sera from our serum libraries. Discussion the implementation of an IH panel has expanded the quality and quantity of the serologic immunohematology services our lab provides. Its creation demands a massive donor phenotyping program and a considerable blood donor database analysis. The rewards in providing the maximum diagnostic quality for our patients is priceless.
Institution: Hospital Central de las Fuerzas Armadas
Language: English
Topic: Blood groups and transfusion
Subfield: Hematology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7223106310