Although the significance of blood transfusion and the following blood banking process have been acknowledged for quite some time, there has been no uniform approach toward the testing process for the detection of antibodies in erythrocytes up until recently.i The concept of a solid phase test was suggested in the 1990s and is based on the idea of immobilizing one of the agents. After the immobilization phase, the agent in question reacts with the additional reactants that can be located in the liquid phase with the following transfer thereof to the solid phase.
In the early ’90s, the Capture-R solid-phase system was designed to carry out the testing processes successfully. The identified serological testing framework proved to have high sensitivity rates for detecting antibodies in the routine environment. However, the areas of its usage are limited to the anti-IgG-based IAT (indirect algorithm test). Afterward, a solid phase enzyme-linked immunosorbent assay (ELISA) was designed by Biotest, Ltd. to improve the automated reading issue, yet it is currently not viewed as commercially promising.
The application of the solid phase testing process delivers more palatable results than the rest of the tests that are traditionally used to detect the blood type for a blood transfusion because of its high sensitivity rates; therefore, it should be considered as the primary means of carrying out the related tests.
Hemolytic Transfusion Reaction (HTR) can be defined as the adverse reaction that a patient develops as a result of the blood transfusion procedure. As a rule, HTR manifests itself in, although it is not restricted to, fever, anemia, urticaria, etc.
The phenomenon of HTR may occur if the patient starts producing antibodies to the red cell antigen that the transfused blood contains yet the patient does not have in their system. Particularly, the absence of the Kidd blood antigen in the patient’s blood and the presence thereof in the blood that has been introduced to the patient’s bloodstream causes the HTR reaction.
HTR manifests itself in two modes, i.e., the acute and the delayed one. In the case of the latter, the negative effects may ensue approximately 12–14 hours after the transfusion. In the instance of an acute HTR, the patient develops resistance to the transfused blood immediately.
As a rule, the following classification is provided for acute HTRs: transfusion-related acute lung injury, or TRALI; bacterial contamination and endotoxemia; nonhemolytic febrile reactions; circulatory (volume) overload; acute hemolytic reactions, and allergic reactions. In TRALI, the human leukocyte antigen and the neutrophil antigens in the patient’s bloodstream react, causing pulmonary edema. The circulatory (volume) overload also causes pulmonary edema since it implies that the coincidental infusion in the patient’s body due to the reaction with the transfused blood should occur.