Phantom Antibodies: A Clinical Dilemma

Abstract

Background: Detection of clinically insignificant antibodies unrelated to blood group antigens, such as antibodies against preservatives of reagent red cell constituents during routine red cell antibody screening, can cause serological interference, reagent expenditure, and wasted human resources. Interpreting these antibodies often requires extensive immunohematological workup to exclude clinically significant antibodies. Objectives: This study aimed to analyse the interference of clinically insignificant antibodies against preservatives in reagent red cells at our Immunohematological Regional Reference Centre. Materials and Methods: A retrospective study was done in which we reviewed our Immunohematology laboratory records for cases involving anti-preservative antibodies against reagent red cells. Data for a period of 12 months (from January 2024 to December 2024) were reviewed. Results: During this period, we received a total of 113 cases. Among these, 3 cases with anti-preservative antibodies against reagent red cells were identified. Among the 3 cases, one case was referred to from an outside hospital in view of a grouping discrepancy, and the other two had positive antibody screening. These antibodies are clinically insignificant and cause hindrance in the regular immunohematological workup. Conclusion: The detection of clinically insignificant antibodies against preservatives in red cell constituents can not only impede the efficient conduct of routine immunohematological investigations but also lead to unnecessary consumption of resources and, consequently, delay critical patient care, and it can be overcome using in-house pooled cells.