La recherche d'anticorps anti-érythrocytaires (RAI) : un examen au cœur de la réforme de la biologie médicale

A reform of the medical biology has been launched since 2010. Once implemented, it resulted in a reorganization of the clinical laboratories, mostly a centralization of laboratory analytics within core laboratories. The red blood cell (RBC) antibody screening and identification are subjected to the organizational constraints of the reform, because these tests may be operated in core laboratories that are distant from healthcare structures while they ensure the safety of RBC transfusion. In the routine antibody identification, the result interpretation may be challenging and the samples can also be transmitted to reference laboratories, in which additional methods are used to resolve analytical problems. However, the RBC antibody screening and identification have a direct impact on the types of the packed RBC to release and the test result determines the need for a cross matching that enhances transfusion safety. During pregnancy, these tests are also a key component of the prevention of allo-immunization against RH1 antigen and feto-maternal incompatibility. Therefore, the optimization of laboratory logistics which relies on the close cooperation between the lab and the blood banks on the one hand, and the hospitals trained to handle high-risk pregnancies on the other hand, is of particular importance for a full efficiency of the transfusion procedure and the follow-up of pregnancies.