Background: Extensive studies have been conducted on the in vitro effects of diaspirin-crosslinked hemoglobin (DCLHb) in biochemical, hematologic, hemostatic, and blood banking (immunohematologic) methods. The absence of red cell antigens or plasma and/or serum antibodies allows DCLHb to be used as "universal-donor" material. This study evaluates the effects of DCLHb on the accurate assessment of the immunohematologic profile (ABO and Rh blood grouping, antibody screen, and crossmatching).
Study design and methods: DCLHb, 7.4 g per dL in an electrolyte solution, was mixed in vitro with human whole blood, representing the blood types A Rh-positive. A Rh-negative, B Rh-positive, B Rh-negative, O Rh-positive, O Rh-negative, and AB Rh-positive. Two concentrations of DCLHb were tested: 10-percent (0.74 g/dL) and 30-percent (2.22 g/dL). Controls were prepared by adding a 5-percent albumin solution to aliquots of whole blood in volumes equivalent to those used in preparing the DCLHb dilutions. Serum and/or red cell suspensions from these admixed samples were analyzed for their ABO and Rh blood groups, the presence of unexpected antibodies (antibody screen), and compatibility in crossmatch testing.
Results: DCLHb added to whole blood in vitro had no effect on the accurate interpretation of the immunohematologic profile.
Conclusion: DCLHb does not appear to inhibit the true response or crossreact in the analysis of blood grouping, antibody screening, or crossmatching. In addition, the red color of DCLHb (up to 2.22 g/dL) did not obscure the visual reading for agglutination.