Newcastle Laboratories

Isohaemagglutinins

Clinical Background:

Isohaemagglutinin titres are performed as an indicator of immune competence for a variety of clinical conditions e.g. SCID, immune deficiency, BMT, solid organ transplant and in preparation of a pa...

Isohaemagglutinin titres are performed as an indicator of immune competence for a variety of clinical conditions e.g. SCID, immune deficiency, BMT, solid organ transplant and in preparation of a patient undergoing an ABOi solid organ transplant. Isohaemagglutinins are mainly of the IgM class, although IgG antibodies may also be detected, and are the naturally occurring antibodies of the ABO blood group system anti-A and anti-B. Individuals who are of the AB blood group lack isohaemagglutinins so the test will not be performed on this blood group. Anti-A and anti-B can normally be detected after the first 4-6 months of life, although titres are very low up to 1 year of age. The antibody production increases to reach normal adult levels between 5-10 years of age and may decline in later life. The presence of high titres of IgG isohaemagglutinins in IVIg has been associated with significant haemolysis in isolated case reports. Where high doses are to be used, it may be appropriate to titre the IVIg and rule out high titre batches for clinical use in at risk patients. The isohaemagglutinin titre is a semi quantitative method used to determine the concentration of antibody by testing serial doubling dilutions of serum or plasma against selected red blood cells. Results are expressed as the reciprocal of the highest dilution that causes agglutination.

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Test Details

  • Discipline:

    Transfusion

    Transfusion

  • Specimen Container Adult:

    6mL K2 EDTA

    6mL K2 EDTA

  • Specimen Container Paediatric:

    6mL K2 EDTA

    6mL K2 EDTA

  • Minimum Volume Adult:

    6mL

    6mL

  • Minimum Volume Paediatric:

    2mL

    2mL

  • Special Requirement:

    Test can be ordered via EPR PowerChart and taken with the BloodTrack bedside sample labelling system.
    The Trust operates a zero tolerance policy. Deviation from Trust Sample Labelling Policy will re...

    Test can be ordered via EPR PowerChart and taken with the BloodTrack bedside sample labelling system.
    The Trust operates a zero tolerance policy. Deviation from Trust Sample Labelling Policy will result in the sample being rejected and a repeat requested.

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  • Sample Stability:

    Short term storage: 24 hours at room temperature.
    Long term storage: 7 days at 4-6°C

    Short term storage: 24 hours at room temperature.
    Long term storage: 7 days at 4-6°C

  • Transport Requirements:

    Sample should be transported to Laboratory Medicine Reception via GP courier, hospital air-tube system or hand delivered to maintain storage conditions. Samples must not be subjected to extreme hot...

    Sample should be transported to Laboratory Medicine Reception via GP courier, hospital air-tube system or hand delivered to maintain storage conditions. Samples must not be subjected to extreme hot or cold conditions prior to testing.

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  • Add On Test:

    Request for add on must be discussed directly with the Transfusion laboratory.
    FH: 0191 2237849
    RVI: 0191 2824435

    Request for add on must be discussed directly with the Transfusion laboratory.
    FH: 0191 2237849
    RVI: 0191 2824435

  • Interpretation:

    The Isohaemagglutinin titre is reported as the highest dilution to give a macroscopic agglutination reaction subject to satisfactory control results. The absence of agglutination, when the patient&...

    The Isohaemagglutinin titre is reported as the highest dilution to give a macroscopic agglutination reaction subject to satisfactory control results. The absence of agglutination, when the patient’s diluted plasma is tested against appropriate red cells, indicates that anti-A and/or anti-B are not detectable. Results are expressed as the reciprocal of the highest dilution that causes agglutination (e.g. 1/4, 1/64 etc.)

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  • Factors Affecting Result:

    Insufficient plasma/serum or haemolysed specimen may give incorrect result. High haematocrit can cause insufficient plasma for testing. Technical variables affect results and care should be taken t...

    Insufficient plasma/serum or haemolysed specimen may give incorrect result. High haematocrit can cause insufficient plasma for testing. Technical variables affect results and care should be taken to achieve a uniform practice.

    Careful pipetting is essential

    Optimum time and temperature must be consistent

    Age, phenotype and concentration of test cells will influence results

    For reproducibility of results comparisons with previous tested samples should be performed concurrently when available.

    Measurements are more accurate with large volume dilutions than with small volumes.

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  • Referenced Documents:

    4/19/15

    4/19/15

  • Routine Contact Name:

    FH Section Leads
    RVI Section Leads

  • Routine Telephone:

    Freeman: 0191 213 7849
    RVI: 0191 282 4335

    Freeman: 0191 213 7849
    RVI: 0191 282 4335

  • Specialist Test:

    Yes

    Yes

  • Specialist Contact Name:

    Transfusion manager

    Transfusion manager

  • Specialist Telephone:

    0192 213 9169

    0192 213 9169

Availability:

Routine core hours only unless part of a previously agreed protocol (e.g. during ABO mismatched transplant).

Turn Around:

Routine: Up to 7 days
Urgent: 4 hours

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