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Laboratory Techniques

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8. Laboratory Techniques

Serology techniques

The laboratory has multifold activities

Processing of donor blood
Pretransfusion testing of recipient
Preparation of components
Quality control procedures
Histo-compatibility testing (optional)

Erroneous results in serological testing may prove fatal in a blood transfusion laboratory.

All laboratory samples must be preserved for at least 7 days after the test. Any transfusion reactions reported to the blood transfusion service must be properly worked-up with detailed repeat laboratory testing on donated unit and recipient’s samples (pre-and post-transfusion). A complete record of the type of transfusion reaction and results of the investigation must be kept.

Adequate controls must be set up with each technique to avoid false reactions.

Screening for transfusion transmitted diseases

Efforts are made in all transfusion services to reduce the risk for transfusion transmitted diseases. Infections for which screening should be done depends on endemic infections in that area e.g., parasite, bacteria and viruses; and funds available.

It is mandatory in India, to screen all donated blood units far Hepatitis B viral infection (HBsAg), HIV infection (anti-HIV-1 and anti-HIV-2), syphilis (anti-treponemal antibodies by VDRLJTPHA test) and malaria (peripheral blood smear examination), and HCV.

To achieve the goal of transfusion safety and prevent transfusion - transmitted infections it is imperative to use highly sensitive and specific test assay systems to detect weak reactions.

The test assay system or test kits should be revalidated. Procedures should be strictly adhered to and appropriate test and internal control (positive and negative) must be put with each batch of test. A test run validity and proper calculations are also important to avoid any false-negative or positive results.

The donated units with a positive marker of infection must be isolated soon after completion of the test and discarded after proper disinfection or incinerated if facility is available.

A continuous supply of validated test kits is essential for successful screening of all donated units. Adequate storage of kits at recommended temperature must be maintained for proper functioning of the test kits and reagents.

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