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The page below is a sample from the LabCE course Antibody Detection and Identification. Access the complete course and earn ASCLS P.A.C.E.-approved continuing education credits by subscribing online.

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Is It a Cold or a Warm Autoantibody?

Cold antibody
  • Immediate spin screen and panel cell reactions will be positive (W+ to 4+). The auto control may also be positive.
  • AHG reactions may be weakly positive if the cold antibody is bound strongly to the red cells.
  • Prewarming should prevent binding from occurring.
Warm antibody
  • Immediate spin reactions on screen cells, panel cells, and auto control are usually negative
  • AHG reactions will be positive including auto control (W+ to 4+).
  • Prewarming of sample and reagents will not change positive reactions since they react best at 37°C and AHG phase. So, reactions will still be positive.
  • Elution and autoadsorption techniques may be used to help further identify the antibody or to help identify other clinically significant antibodies that may be present.
Autoadsorption is a technique that involves adsorbing unbound autoantibody from the patient's serum using the patient's own red cells. Once the autoantibody is removed, then testing can be performed to determine if any clinically significant antibodies are present. This is only possible when the patient has not been recently transfused. If donor cells are still in circulation, alloantibodies may also be adsorbed. In these cases phenotypically similar reagent cells may be used for an alloadsorption procedure.