Efficacy of performing red-cell antibody elutions in patients with a positive direct antiglobulin test.

Red blood cell antibody elutions are often routinely performed whenever a positive direct antiglobulin test (DAT) is encountered. To evaluate the efficacy of performing routine red-cell elutions we reviewed our antibody elution data. Of 122 eluates, 83 were negative, 35 were warm panagglutinins, 2 were felt to be transfusion-induced alloantibodies, 1 was passively acquired anti-A, and 1 was inconclusive. One of the eluted alloantibodies was not demonstrable in the serum. Thus, only 1 (0.8%) of the eluates provided important information not readily available through serum testing alone. We conclude that extensive serologic evaluation of a positive DAT should be reserved for those patients who have been recently transfused or are suspected of having immune hemolysis.