Establishing the application of Monocyte monolayer assay (MMA) in predicting the clinical significance of the red cell antibody.

Patients requiring best matched blood unit transfusion due to auto or allo antibodies based on the routine immunohematological work up performed will be included in the study after obtaining informed consent. Routine immunohematological work up includes Direct and indirect antiglobulin testing (DAT & IAT), Monospecific DAT, thermal amplitude of the antibody, as indicated). As per the departmental protocol, a crossmatch of 4-6 units of donors will be crossmatched with patient’s sample. The same donor samples will be utilized to assess the MMA index.  The basic principle of the test is Monocytes, the immune cells that destroy red blood cells during an adverse transfusion reaction, are isolated and placed in a single layer on a plate in the laboratory. The donor red blood cells are mixed with the patient’s antibodies and added to the monocytes. The number of monocytes with one or more red blood cells adhered/engulfed at the end of the assay is counted and this is used to calculate a “monocyte indexâ€.