Preparing and testing an elution from red blood cells is a tedious and expensive process. Veeraputhiran et al listed criteria for when to perform the test. The authors are from the University of Arkansas and Arkansas Children's Hospital in Little Rock.


Goal: to reduce the number of unnecessary elutions


Premises made:

(1) Both alloimmune transfusion reactions and autoantibodies are considered together in the analysis.

(2) The endpoint was whether or not the elution would influence a change in transfusion practice.

(3) The analysis included both pediatric and adult patients.


Situations when an elution was usually not indicated:

(1) negative direct antiglobulin test (DAT)

(2) no history of a recent blood transfusion (within the past month)

(3) previous DAT result AND current strength less, the same or 1 reaction grade higher


Situations when an elution may be indicated:

(1) DAT positive and recent blood transfusion

(2) DAT positive and no previous positive DAT (first detection)

(3) DAT positive and reaction strength increased > 1 grade


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