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. 2020 Mar;34(2):941-948.
doi: 10.1111/jvim.15710. Epub 2020 Feb 4.

Agreement of stall-side and laboratory major crossmatch tests with the reference standard method in horses

Melissa S Fenn  1 , Araba D Bortsie-Aryee  2 , Gillian A Perkins  1 , Sabine Mann  2 , Joy E Tomlinson  3 , Emma M Wood  2 , Susan E Mix  2 , Tracy Stokol  2
Affiliations

Agreement of stall-side and laboratory major crossmatch tests with the reference standard method in horses

Melissa S Fenn et al. J Vet Intern Med. 2020 Mar.

Abstract

Background: Crossmatching is used to prevent life-threatening transfusion reactions in horses. Laboratory methods are laborious and technically challenging, which is impractical during emergencies.

Hypothesis/objectives: Evaluate agreement between a stall-side crossmatch kit (KIT) and a laboratory method (LAB) in horses with known and unknown blood types.

Animals: Twenty-four blood-typed and alloantibody-screened healthy adult horses (Aim 1) and 156 adult horses of unknown blood type (Aim 2).

Methods: Prospective, blinded study. Expected positive (n = 35) and negative (n = 36) crossmatches among 24 antibody and blood-typed horses were used to determine sensitivity and specificity of KIT and LAB against the reference method. Agreement in 156 untyped horses was evaluated by reciprocal crossmatch (n = 156).

Results: Sensitivity (95% confidence interval [CI]) for LAB and KIT compared with expected reactions was 77.1% (59.9%-90.0%) and 91.4% (77.0%-98.2%), and specificity 77.8% (60.9%-89.9%) and 73.5% (55.6%-87.1%), respectively. The KIT was 100% sensitive for Aa reactions; LAB was 100% sensitive for Qab; and both were 100% sensitive for Ca. Cohen's κ agreement for LAB and KIT with expected positive and negative reactions (n = 71) was moderate (0.55 [0.36-0.74]) and substantial (0.65 [0.47-0.82]), respectively. Agreement was fair comparing LAB with KIT in Aim 1 (0.30 [0.08-0.52]) and in untyped horses in Aim 2 (0.26 [0.11-0.41]).

Conclusions and clinical importance: Agreement between KIT and LAB with expected reactions was blood type dependent. Performance of both methods depends on blood type prevalence.

Keywords: agglutination; alloantibody; blood incompatibility; blood type; point-of-care test; transfusion reaction.

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Conflict of interest statement

Authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Scoring of agglutination in a crossmatch with the stall‐side kit (KIT). The degree of RBC retention in the gel is graded according to the following scale: 0, all RBCs at the bottom of the gel (compatible); 1+, few RBC agglutinates in the lower half of the gel but most RBCs at the bottom of the gel; 2+, RBC agglutinates dispersed throughout the gel, 3+, RBC agglutinates throughout gel and RBCs on upper surface. RBC retention of ≥1+ is considered incompatible
See this image and copyright information in PMC

References

    1. Hurcombe SD, Mudge MC, Hinchcliff KW. Clinical and clinicopathologic variables in adult horses receiving blood transfusions: 31 cases (1999–2005). J Am Vet Med Assoc. 2007;231(2):267‐274. 10.2460/javma.231.2.267. - DOI - PubMed
    1. Mudge MC, Walker NJ, Borjesson DL, Librach F, Johns JL, Owens SD. Post‐transfusion survival of biotin‐labeled allogeneic RBCs in adult horses. Vet Clin Pathol. 2012;41(1):56‐62. 10.1111/j.1939-165X.2011.00384.x. - DOI - PubMed
    1. Smith BP, ed. Large Animal Internal Medicine. Fifth ed. St. Louis, MO: Elsevier Mosby; 2015.
    1. Tomlinson JE, Taberner E, Boston RC, Owens SD, Nolen‐Walston RD. Survival time of cross‐match incompatible red blood cells in adult horses. J Vet Intern Med. 2015;29(6):1683‐1688. 10.1111/jvim.13627. - DOI - PMC - PubMed
    1. Owens SD, Snipes J, Magdesian KG, Christopher MM. Evaluation of a rapid agglutination method for detection of equine red cell surface antigens (Ca and Aa) as part of pretransfusion testing. Vet Clin Pathol. 2008;37(1):49‐56. 10.1111/j.1939-165X.2008.00003.x. - DOI - PubMed

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