A Nine-month Transfusion Service Experience with Low-ionic-strength Saline Solution (LISS)

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Abstract
Blood group antibody detection and patient crossmatch studies were undertaken in a hospital transfusion service to compare a low-ionic-strength saline medium with a conventional saline-albumin isotonic medium. All tests were performed in parallel in both media. Sera from 93 patients were tested. Forty Rh and 53 non-Rh antibodies were examined. Two clinically significant antibodies, anti-E and anti-Lea, were detected only by low-ionic-strength saline medium. Two antibodies reactive only at room temperature, anti-E and anti-P1, were not detected by the low-ionic-strength saline medium with a 12-minute incubation. There was no nonspecific reaction. The parallel crossmatch study included 595 patients with 1,513 routine and problem crossmatches. There were eight nonrepeatable positive reactions by the saline-albumin method and only one with the low-ionic-strength saline medium method. Three clinically significant antibodies, anti-E, anti-Lea, and anti-P1, were detected only by the low-ionic-strength saline crossmatch. A four-month comprehensive review of the routine use of low-ionic-strength saline solution in 2,939 hospital investigations, including antibody screens, crossmatches, and 2,317 donor work-ups, revealed a general enhancement of antibody sensitivity, no nonspecific reaction, an albumin savings of 37%, and an average savings of 13 minutes per twounit crossmatch procedure. This review demonstrates that a low-ionic-strength saline medium can safely be used routinely in the blood bank laboratory for antibody screening and crossmatch procedures.

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