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Immunohaematology I
Lesson 3: ABO Typing Procedure
2. Hemolysis
Sometimes, the antigen-antibody reaction
may result in hemolysis due to activation of
the complement system
Complement, if present in the antiserum, can
bind to the antigen-antibody complex, and
lyse the red cells
Complement can be easily inactivated by
heating at 56C for 30 minutes
3. Rouleaux formation
A high concentration of globulin in patients
serum can hold the red cells together to
appear like a stack of coins
This is rouleaux formation and can be
mistaken for agglutination
Anti-B
AB
B cells
O cells
AB
Gel Typing
Automated and semi-automated systems are
available for blood grouping and
crossmatching
Solid-phase and gel or column typing methods
can be automated allowing some walk-away
testing
Gel typing
Sensitive and specific
The procedure can be standardized, verified
and validated
Testing is performed in a card prefilled with
gels mixed with the appropriate reagent
A dilution of patient cells is pipetted onto the
gel column and the card is incubated
The card is centrifuged and read
Plasma Abnormalities
1. Increased gamma globulin disease e.g.
multiple myeloma, Hodgkins lymphoma
rouleaux formation
2. Abnormal proteins causing rouleaux
formation
3. Whartons jelly found only when cord blood
is used
Rouleaux - stacks of red blood cells (RBCs)
which form because of the unique discoid
shape of the cells
Rouleaux