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
