Ebram Immunohematology: Accuracy and reliability

A immunohematology is the study of the antigens present on red blood cells, their corresponding antibodies and their clinical significance. It is a specialty of hemotherapy, directly related to transfusion medicine.

In addition to being essential for diagnosing hematological pathologies such as fetal erythroblastosis and autoimmune hemolytic anemias, immunohematological analyses play an important role in preventing transfusion reactions. They help mitigate the risks related to blood compatibility between donor and recipient, ensuring therapeutic efficacy and the safety of the donation process.

Among these pathologies, fetal erythroblastosis, also known as hemolytic disease of the newborn, occurs when the mother's antibodies attack the fetus' red blood cells due to blood incompatibility, causing jaundice, anemia, swelling and, in severe cases, fetal death. Autoimmune hemolytic anemia occurs when the patient's immune system produces antibodies that attack their own red blood cells, leading to premature destruction of the red blood cells. Finally, hemolytic transfusion reactions occur when the recipient's immune system attacks the red blood cells in the donated blood due to blood incompatibility. The main triggering factor is incompatibility between the donor's and recipient's blood groups, where the antigens present on the donor's RBCs are recognized as foreign by the recipient's plasma antibodies. This leads to activation of the complement system and breakdown of the red blood cells. In addition to ABO and Rh incompatibility, other less common erythrocyte antigens may be involved. Factors such as the presence of irregular antibodies, errors in the identification of the patient or blood component, and bacterial contamination can also contribute to the development of these reactions.

The immunohematology are essential tools for the prevention and diagnosis of these pathologies. The main techniques used in immunohematology include blood typing, which determines the ABO and Rh blood group of the donor and recipient, irregular antibody testing (IAP), which detects the presence of antibodies against erythrocyte antigens other than ABO and Rh in the recipient's plasma, and the Coombs test, which is used to detect antibodies attached to red blood cells.

Given the importance of immunohematology tests in blood banks, strict minimum specifications are established for the reagents used. These specifications include avidity, titration and score.

Cravingavidity measures the strength of the binding between antibody and antigen. High avidity indicates strong and rapid binding, resulting in more accurate and reliable reactions.
Titletitration is used to determine the concentration of antibodies in serum. This test is important for checking the amount of antibodies needed to generate a visible reaction in laboratory tests.
ScoreThe score is a way of quantifying the intensity of the reaction between the antibody and the antigen, providing an objective measure of the strength of the agglutination.

Ebram is concerned with meeting and exceeding the quality expectations of our products. That's why we supply blood banks and clinical laboratories with reagents with titration and score specifications that are above requirements, as well as a faster avidity time than recommended, as shown in the table below.

Reagent	Red blood cells	Craving		Title		Score
Reagent	Red blood cells	Blood bank specification	Results obtained with EBRAM reagents	Minimum specification for the blood bank	Results obtained with EBRAM reagents	Minimum specification for the blood bank	Results obtained with EBRAM reagents
Anti-A	A1	Up to 15s	6s	1:256	1:512	72	101
Anti-A	A2	Up to 30s	13s	1:128	1:256	60	98
Anti-B	B	Up to 15s	4s	1:256	1:512	72	97
Anti-AB	A1	Up to 15s	5s	1:256	1:512	72	106
	A2	Up to 15s	8s	1:128	1:256	72	97
	B	Up to 30s	10s	1:128	1:256	60	96
Anti-D	Rh+	Up to 30s	21s	1:32	1:64	Not applicable	Not applicable

These specifications demonstrate our commitment to reagent quality.

Ebram's Immunohematology product line is divided into reagents for the ABO System, Rh System and Complementary Reagents. The reagents meet the quality standards set by Anvisa mentioned above. In addition, the results are consistent and reproducible, guaranteeing precision and stability, with no variations between batches.

ABO system

Anti-A serum: identifies the A antigen. It is a monoclonal serum of the IgM type, which reacts with A1, A2 and AB red blood cells.
Anti-B serum: identifies the B antigen. It is a monoclonal serum of the IgM type, which reacts with B and AB red blood cells.
Anti-AB serum: identifies both A and B antigens. It is a monoclonal serum of the IgM type, which reacts with A1, A, B and AB red blood cells, as well as detecting subgroups of A, such as A1, A2, A3, Ax and Aend. It is used as a control, to confirm typing with the Anti-A and Anti-B sera and is especially used in neonatal typing or umbilical cord red cells, where antigenic expression may be weaker. Because it contains both antibodies, the Anti-AB serum increases the chance of detecting these antigens effectively.

Rh system

Anti-D serum: identifies the D antigen (Rh factor), determining whether the blood is positive or negative (Rh positive or Rh negative). It is a monoclonal serum of the blended type, which combines IgG and IgM in a single formulation. It is able to agglutinate all weak red cells (D1) and detect category D red cells VI.
Rh control: used as a control for Rh classifications, to identify possible false-positive Anti-D reactions caused by autoantibodies.
Anti-Human Serum: used in cross tests and direct or indirect Coombs tests to detect human IgG (all 4 subclasses) and certain C3d fragments bound to red blood cells, clinically significant antibodies which are not detected by the direct method.

Differential: when we compare the anti-human serum reagent and the Coombs serum reagent on the market, although the two have similar uses, there is a difference in composition, the anti-human serum combines antibodies against IgG and C3d, while the Coombs serum is specific for IgG, which makes the anti-human serum more sensitive, capable of detecting a wider range of antibodies, reducing false positive results, especially when complement is activated.

Complementary reagents:

Bovine Albumin 22%: used to enhance the sensitivity of some specific antibodies in the indirect antiglobulin test and to enhance antigen-antibody reactions. Incomplete antibodies can bind to their antigens in the first stage of agglutination, but without causing visible agglutination. The addition of bovine albumin 22% to this cell suspension is able to make these antibodies complete the 2nd stage of agglutination, making it visible.

Ebram is one of the leading sellers of immunohematology reagents in the national market. We have been a benchmark for quality in these products for 30 years. We always strive to provide our customers with products that meet and exceed their needs, and the reagents in the immunohematology line are a great example of our commitment, since they always have specifications above those required and are validated and approved by blood banks throughout Brazil.

Contact

Visit the website and learn more about the Immunohematology Line.

You can also contact us through our service channels, staffed by specialists who are ready to answer all your questions:SAC 0800 500 2424 | e-mail: sac@ebram.com
Commercial department: 11 2291-2811 - e-mail: vendas@ebram.com

Quality and reliability: Get to know Ebram's hematology laboratory range

Ebram Immunohematology: Accuracy and reliability

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