I.

Additional Techniques for Resolving Antibody

Identification
There may be times when the initial antibody
identification panel does not reveal a cleancut
specificity.
When multiple specificities remain following the exclusion
and inclusion process, additional testing is necessary.

a.Selected Panel
The simplest step to take is to test additional cells from
a different panel.
Selected cell panels are useful when a patient has a
known antibody and technologist is attempting to
determine if additional antibodies are present.

b.Enzymes
When it appears that multiple antibodies may be
present in a sample, treating the panel cell with
enzymes may help separate the specificities and allow
for identification.
Ficin is commonly used to treat RBCs; however
papain, bromelin, or trypsin may also be used.
Enzymes modify the RBC surface by removing sialic
acid residues and by denaturing or removing
glycoproteins.
The effect is to destroy certain antigens and
enhance expression of others.
Enzymes may be utilized in place of enhancement
media, such as LISS or PEG, in one-step enzyme test
method.
A second, more sensitive method uses enzymes to treat
the panel RBCs first, and then the antibody
identification panel is performed using the treated
cells.

 Because enzymes destroy antigens, not all

specificities can be excluded using the enzyme
panel alone.
When possible, the reactivity of cells on the enzyme
treated panel should be compared to the reactivity of
the same cells before enzyme treatment.