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Panagglutination on the indirect antiglobulin test... This is the challenge!
Styliani I Kokoris1, Dimitrios Kalantzis1, Dimitra Moschandreou2, Konstantina Papaioannou2, Elisavet Grouzi2
1 Laboratory of Hematology and Hospital Blood Transfusion Department, Medical School, University General Hospital ‘Attikon’, National and Kapodistrian University of Athens, Chaidari, Athens, Greece
2 Department of Transfusion Service and Clinical Hemostasis, ‘Saint Savvas’ Oncology Hospital, Athens, Greece
Correspondence Address:
Elisavet Grouzi,
Department of Transfusion Service and Clinical Hemostasis, ‘Saint Savvas’ Oncology Hospital, Athens
Greece
 Source of Support: None, Conflict of Interest: None DOI: 10.4103/ajts.ajts_133_20
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Panagglutination on the indirect antiglobulin test is one of the most challenging dilemmas of pretransfusion testing. It occurs when patient sera react with all red blood cells tested, that is, with both screening and identification panel cells. Two main questions must be answered. The first is to determine whether panagglutination results from the presence of autoantibody and/or alloantibody (single alloantibody or multiple alloantibodies or antibody to high-incidence antigen). The second problem is to detect the possible concomitant presence of clinically significant alloantibodies masked by panagglutination. The purpose of this mini-review is to describe the situations that can cause panagglutination and to develop algorithms which can resolve the problem. The two main points in the evaluation of panagglutination involve the assessment of the intensity of reactivity with the reagent red cells used and whether the autocontrol is positive or not. It is imperative to understand the laboratory results and the techniques available that guide the investigative process.
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