혈액은행 자동화 검사장비 ORTHO VISION를 이용한 ABO 항체역가검사의 평가 = Evaluation of the Automated Immunohematology Analyzer ORTHO VISION for ABO Antibody Titration

다국어 초록 (Multilingual Abstract)

Background: ABO antibody titration is important in cases such as ABO incompatible hemolytic disease of the fetus and newborn (HDFN), ABO incompatible bone marrow, or solid organ transplantation. This study was conducted in order to evaluate usability of ORTHO VISION (Ortho Clinical Diagnostics, Raritan, USA) designed automated ABO antibody titration equipment.
Methods: The isoagglutination titers were determined in 80 subjects (20 A, 20 B, 40 O (anti-A 20, anti-B 20)) using a conventional tube technique, including a 30 minute room temperature phase (CTT), Dithiothreitol treated manual column agglutination technique (MCAT), and automated column agglutination technique (ACAT) by ORTHO VISION. The concordance of titer was compared within one dilution step between the two methods.
Results: The isoagglutinin titers measured by the ACAT with anti-human globulin poly cassette (ACAT_Poly) and anti-human globulin IgG cassette (ACAT_IgG) were the highest and the isoagglutinin titer measured by the MCAT was also higher than that by the CTT. The isoagglutinin titer measured by the ACAT with reverse diluents cassette (ACAT_Reverse) was similar to that measured by the CTT. The concordance of anti-A and anti-B titers between CTT and ACAT_Reverse was 83% and 68%. The concordance of anti-A and anti-B titers between MCAT and ACAT_Poly was 100% and 83%. The concordance of anti-A and anti-B titers between MCAT and ACAT_IgG was 98% and 88%.
Conclusion: Automated isoagglutinin titration using ACAT_Poly or ACAT_IgG without DTT showed reliable concordance with DTT treated MCAT, and it appears to be a possible replacement for the conventional MCAT method.

국문 초록 (Abstract)

배경: ABO 항체 역가의 측정은 ABO 부적합태아신생아용혈성질환, ABO 부적합 골수 이식및 ABO 부적합 고형장기이식에서 중요한 지표이다. 이에 본 연구에서는 ABO 항체역가 자동화검사가 가능한 ORTHO VISION (Ortho Clinical Diagnostics, Raritan, USA) 장비의 유용성을 평가하였다.
방법: A형 20명, B형 20명, O형 40명(anti-A 20 명, anti-B 20명) 총 80명을 대상으로 30분 실온배양 수기 시험관법 및 dithiothreitol을 처리한 수기 원주응집법과 ORTHO VISION 장비를 사용한자동화 원주응집법을 시행하였다. 역가는 두 방법 간의 희석배수 1단계 이내의 일치율로 비교하였다.
결과: AHG (Anti-human globulin) poly cassette, AHG (Anti-human globulin) IgG cassette를 사용한자동화 원주응집법으로 측정한 동종응집소 역가가 가장 높았으며, 수기 원주응집법 역시 시험관법에 비해 높게 측정되었다. Reverse diluents cassette를사용한 자동화 원주응집법은 시험관법과거의 동일하게 측정되었다. 시험관법과 reverse diluent cassette를 사용한 자동화 원주응집법에 의한 anti-A, anti-B의 일치율은 83%, 68%이었다. 수기 원주응집법과 AHG poly cassette를 사용한 자동화 원주응집법의 anti-A, anti-B의 일치율은 100, 83%이었다. 수기 원주응집법과 AHG IgG Cassette를사용한 자동화 원주응집법의 anti-A, anti-B 의 일치율은 98% 88%이었다.
결론: DTT를 처리하지 않은 AHG poly cassette 또는 IgG cassette를 사용한 자동화 항체역가 측정은 DTT 처리한 수기 원주응집법과 비교적 좋은일치율을 보여주어 기존의 수기 원주응집법을 대체할 수 있을 것으로 사료된다.

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