Incompatibilityin vitroandin vivoDemonstrated Only with Saline-Suspended Red Cells

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Abstract
An unusual Ig[immunoglobulin]G complement-binding antibody was observed in a 64 yr old man prior to surgery. This antibody was detectable by the indirect antiglobulin test when the red cells were suspended in saline, but not when they were suspended in acid citrate dextrose [ACD] or albumin solutions. Positive reactions were obtained with the patient''s own red cells and with the cells of all donors tested. In vivo Cr survival studies showed that donor cells and patient cells, when suspended in saline, had 1 h survivals of 32 and 46%, respectively. Donor and patient cells suspended in ACD solution had 1 h survivals of 77 and 93%, respectively. This phenomenon may cause accelerated destruction of saline-suspended cells and should be suspected whenever in vitro incompatibility is noted only with red cells suspended in saline.