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Evaluation for the Usefulness of Automated Blood Typing Analyzer

혈액은행 자동화 장비 도입의 유용성 평가

  • 김하나 (강원대학교 의과대학 진단검사의학교실) ;
  • 김희범 (강원대학교 의과대학 진단검사의학교실) ;
  • 박현상 (강원대학교 의과대학 진단검사의학교실) ;
  • 이현임 (강원대학교 의과대학 진단검사의학교실) ;
  • 홍명국 (강원대학교 의과대학 진단검사의학교실) ;
  • 신경숙 (강원대학교 의과대학 진단검사의학교실) ;
  • 서인범 (강원대학교 의과대학 진단검사의학교실)
  • Received : 2019.04.15
  • Accepted : 2019.06.17
  • Published : 2019.06.28

Abstract

In this study, we evaluated the usefulness of an automatic blood typing analyzer using QWALYS-2 up (Diagast, Loos Cedex, France). During a month( 01OCT2013 - 31OCT2013) we performed 1,636 tests for ABO & RhD blood typing, 1,374 tests for antibody screen & identification tests and compared the results by automatic blood type analyzer with previous manual methods and column agglutination tests. And we analyzed the economic performance by comparison the test unit price between automatic blood type analyzer and manual methods. In ABO & RhD blood typing tests, there were complete concordances between manual and automated blood typing analyzer for 200 clinical samples. In Antibody screen tests, the concordance rate between manual and automated blood typing analyzer was 98.5% and more strong reaction in automated blood typing analyzer than manual methods. Therefore, the introduction of an automated blood typing analyzer, reagents costs were increased but labor costs were decreased. Considering the importance of transfusion safety and economic advantages, the introduction of an automated blood typing analyzer was very useful.

본 연구는 혈액은행 자동화 장비 QWALYS-2 up (Diagast, Loos Cedex, France)의 유용성을 평가하기 위하여 수행되었다. 2013년 10월 1일부터 10월 31말까지 1개월간 강원대학교병원 진단검사의학과에 의뢰된 ABO 및 RhD 혈액형 검사 1,636건, 항체선별검사 1,374건을 대상으로 하였고, ABO 및 RhD 혈액형 검사의 평가는 200건을 대상으로 하였다. 혈액은행 자동화장비의 경제성을 평가하기 위해서는 2018년 12월을 기준으로 장비 도입 전인 2013년 1월부터 장비 도입 후 5개년의 ABO 및 RhD 혈액형 검사와 항체선별검사의 단가를 비교하였다. 본 연구의 주요 결과는 ABO 및 Rh 혈액형 검사 결과, 슬라이드나 시험관을 이용한 수기법의 결과가 100% (200/200) 일치하였고 동종항체 선별검사 결과, 불일치 3검체는 수기법으로 재검을 한 결과, 음성을 보여 QWALYS-2 up에서 위양성의 결과를 나타냈으나, 반응의 정도를 비교한 결과 QWALYS-2 up에서 상대적으로 높게 나타났다. 결론적으로 혈액형자동화 장비 도입 전후의 효과를 평가한 결과, 기존의 수기법과 비교하였을 때 높은 일치율을 보였으며, 정확도 면에서도 신뢰할 만한 것으로 판단되었다. 도입 전후의 시약의 비용은 증가하였지만 인건비의 절감을 감안하면 경제적으로도 유용하다고 평가할 수 있다.

Keywords

표 1. Comparison of the ABO results between the manual method and QWALYS-2 up

CCTHCV_2019_v19n6_565_t0001.png 이미지

표 2. Comparison of the RhD results between the manual method and QWALYS-2 up

CCTHCV_2019_v19n6_565_t0002.png 이미지

표 3. Comparison of the RhD results between the manual method and QWALYS-2 up

CCTHCV_2019_v19n6_565_t0003.png 이미지

표 4. Comparison of the test number for Blood group typing, Antibody screening test and identi- fication test between pre- (2013') and post-setup (2014', 2015', 2016‘, 2017’ & 2018‘) QWALYS-2 up automated blood typing analyzer

CCTHCV_2019_v19n6_565_t0004.png 이미지

표 5. Comparison of the identified Antibodies between pre- (2013') and post-setup (2014', 2015', 2016‘, 2017’ & 2018‘) QWALYS-2 up automated blood typing analyzer

CCTHCV_2019_v19n6_565_t0005.png 이미지

표 6. Comparison of the price/test for ABO & RhD test between pre- (2013') and post-setup (2014', 2015', 2016‘, 2017’ & 2018‘) QWALYS-2 up automated blood typing analyzer (Price unit, Korean Won)

CCTHCV_2019_v19n6_565_t0006.png 이미지

표 7. Comparison of the price/test for Antibody screen & identification test between pre- (2013') and post-setup (2014', 2015', 2016‘, 2017’ & 2018‘) QWALYS-2 up automated blood typing analyzer (Price unit, Korean Won)

CCTHCV_2019_v19n6_565_t0007.png 이미지

References

  1. T. H. Kim, "Factor Analysis about the Deficiency of Blood for the Transfusion," J. Kor. Soc Hygenic Sciences, Vol.13, No.2, pp.45-50, 2007.
  2. C. W. Chung, G. B. Kang, K. H. Min, Y. H. Whang, H. K. You, C. K. Chung, D. H. Park, and W. S. Kim, "Clinical Observation of the Patient who received Blood Transfusion," J. Kor. Anesthesiology, Vol.17, No.2, pp.187-198, 1984. https://doi.org/10.4097/kjae.1984.17.3.187
  3. C. T. Stephens, S. Gumbert, and J. B. Holcomb, "Trauma-associated bleeding: management of massive transfusion," Curr Opin Anaesthesiol, Vol.30, Epub, 2016
  4. L. B. Holst, "Benefits and harms of red blood cell transfusions in patients with septic shock in the intensive care unit," Dan Med J, Vol.63, No.2, 2016.
  5. M. Mainou, F. Alahdab, A. A. Tobian, N. Asi, K. Mohammed, M. H. Murad, and B. J. Grossman, "Reducing the risk of transfusion-transmitted cytomegalovirus infection: a systematic review and meta-analysis," Transfusion, Vol.29, 2016.
  6. T. Gallagher, S. Darby, M. Vodanovich, L. Campbell, and J. Tovey, "Patient blood management nurse vs transfusion nurse: is it time to merge?," Br J Nurs, Vol.24, No.9, pp.492-495, 2015. https://doi.org/10.12968/bjon.2015.24.9.492
  7. J. J. Lefrere and B. Danic, "Transfusion and blood donation in comic strips," Transfus Med, Vol.27, No.3, pp.154-165, 2013. https://doi.org/10.1016/j.tmrv.2012.11.002
  8. J. Meier, D. Filipescu, S. Kozek-Langenecker, J. Llau Pitarch, S. Mallett, P. Martus, and I. Matot, "Intraoperative transfusion practices in Europe," Br J Anaesth, Vol.116, No.2, pp.155-161, 2016. https://doi.org/10.1093/bja/aev446
  9. S. R. Brohi and M. Dilber, "Use of Blood Transfusion Set in Intraventricular Neuroendoscopy," J Coll Physicians Surg Pak, Vol.26, No.1, p.77, 2016.
  10. W. I. Mauka, M. J. Mahande, S. E. Msuya, and R. N. Philemon, "Factors Associated with Repeat Blood Donation at the Northern Zone Blood Transfusion Centre in Tanzania," J Blood Transfus, pp.1-6, 2015.
  11. K. A. Smith, "Documentation of blood for transfusion," J R Army Med Corps, Vol.137, No.2, pp.107-108, 1991.
  12. J. Philip, N. Kushwaha, T. Chatterjee, and R. S. Mallhi, "Optimizing cord blood collections: Assessing the role of maternal and neonatal factors," Asian J Transfus Sci, Vol.9, No.2, pp.163-167, 2015. https://doi.org/10.4103/0973-6247.162714
  13. G. Girelli, S. Antoncecchi, A. M. Casadei, A. Del Vecchio, P. Isernia, M. Motta, D. Regoli, C. Romagnoli, G. Tripodi, and C. Velati, "Recommendations for transfusion therapy in neonatology," Blood Transfus, Vol.13, No.3, pp.484-497, 2015.
  14. J. D. Maciel, E. Gifford, D. Plurad, C. de Virgilio, S. Bricker, F. Bongard, A. Neville, J. Smith, B. Putnam, and D. Kim, "The impact of a massive transfusion protocol on outcomes among patients with abdominal aortic injuries," Ann Vasc Surg, Vol.29, No.4, pp.764-769, 2015. https://doi.org/10.1016/j.avsg.2014.11.024
  15. J. C. Zimring and S. L. Spitalnik, "Pathobiology of transfusion reactions," Annu Rev Pathol, Vol.10, pp.83-110, 2015. https://doi.org/10.1146/annurev-pathol-012414-040318
  16. L. S. Squires, "A case study of recipient twin surviving complications of twin-to-twin transfusion syndrome," Nurs Womens Health, Vol.17, No.5, pp.390-398, 2013. https://doi.org/10.1111/1751-486X.12062
  17. A. Amid, N. Barrowman, A. Vijenthira, P. Lesser, K. Mandel, and R. Ramphal, "Risk factors for hyperferritinemia secondary to red blood cell transfusions in pediatric cancer patients," Pediatr Blood Cancer, Vol.60, No.10, pp.1671-1675, 2013. https://doi.org/10.1002/pbc.24629
  18. A. Pavlova and J. Oldenburg, "Defining severity of hemophilia: more than factor levels," Semin Thromb Hemost, Vol.39, No.7, pp.702-710, 2013. https://doi.org/10.1055/s-0033-1354426
  19. C. M. Peach, J. J. Morrison, A. N. Apodaca, G. Egan, H. G. Watson, and J. O. Jansen, "Destination healthcare facility of shocked trauma patients in Scotland: analysis of transfusion and surgical capability of receiving hospitals," Surgeon, Vol.11, No.5, pp.272-277, 2013. https://doi.org/10.1016/j.surge.2013.01.003
  20. S. G. Sandler, A. Langeberg, D. H. Rumsey, and S. C. Novak, "A solid phase and microtiter plate hemagglutination method for pretransfusion compatibility testing," Haematologia, Vol.30, No.3, pp.149-157, 2000. https://doi.org/10.1163/156855900300109143
  21. G. Daniels, "Molecular blood grouping," Vox Sang, Vol.87, No.1, pp.63-66, 2004. https://doi.org/10.1111/j.1423-0410.2004.00525.x
  22. O. Arslan, "Electronic crossmatching," Transfus Med Rev, Vol.20, No.1, pp.75-79, 2006. https://doi.org/10.1016/j.tmrv.2005.08.007
  23. R. C. Knight and G. D. Poole, "Detection of red cell antibodies: current and future techniques," Br J Biomed Sci, Vol.52, No.4, pp.279-305, 1995.
  24. W. Malomgre and B. Neumeister, "Recent and future trends in blood group typing," Anal Bioanal Chem, Vol.393, No.5, pp.1443-1451, 2009. https://doi.org/10.1007/s00216-008-2411-3
  25. E. Ching, "Solid Phase Red Cell Adherence Assay: a tubeless method for pretransfusion testing and other applications in transfusion science," Transfus Apher Sci, Vol.46, No.3, pp.287-291, 2012. https://doi.org/10.1016/j.transci.2012.03.018
  26. J. R. Storry, "New technologies to replace current blood typing reagents," Curr Opin Hematol, Vol.14, No.6, pp.677-681, 2007. https://doi.org/10.1097/MOH.0b013e3282ef1838
  27. W. H. Ouwehand and T. B. Wallington, "Adaptive immunity and transfusion," Vox Sang, Vol.87, No.1, pp.35-38, 2004. https://doi.org/10.1111/j.1741-6892.2004.00488.x
  28. C. M. Westhoff, "The Rh blood group system in review: a new face for the next decade," Transfusion, Vol.44, No.11, pp.1663-1673, 2004. https://doi.org/10.1111/j.0041-1132.2004.04237.x
  29. S. F. Parsons, "Monoclonal antibodies in blood group serology," Med Lab Sci, Vol.42, No.4, pp361-366, 1985.
  30. D. L. Siegel, "Phage display tools for blood typing," Curr Hematol Rep, Vol.4, No.6, pp.459-464, 2005.
  31. M. L. Olsson, "New developments in immunohaematology," Vox Sang, Vol.87, No.2, pp.66-71, 2004. https://doi.org/10.1111/j.1741-6892.2004.00454.x
  32. K. H. Shin, H. H. Kim, C. L. Chang, and E. Y. Lee, "Economic and Workflow Analysis of a Blood Bank Automated System," Ann Lab Med, Vol.33, No.4, pp.268-273, 2013. https://doi.org/10.3343/alm.2013.33.4.268