AABB2025: In-House RBC Antigen Typing May Offer Cost Savings and Faster Availability

Finding compatible red blood cell (RBC) units for patients with complex antibodies can be time-consuming and resource-intensive for hospitals. At Saturday’s oral abstract session, “Lessons From the Immunohematology Lab,” Jonathan Singher, MLS(ASCP)CM, of Trinity Health shared results from a study showing that in-house antigen typing could save money while keeping units ready for transfusion.

Singher and his co-investigators developed a model to compare automated and manual in-house typing of C, c, E and K antigens with ordering antigen-negative units from a blood supplier, projecting costs and tech time over six months. Testing 12 RBCs for C, c, E and K in-house costs $43.53 and takes about 1 hour using automation, compared with $45.36 and 1.5 hours manually.

The model showed that typing a single antigen-negative unit in-house could save up to $80 compared with ordering from a supplier. Weekly automated screening of 12 O-positive RBCs would cost $1,132 and require 26 hours of tech time over six months, while manual typing and ordering as needed would cost $1,885 and take six hours. Singher noted that automation requires more tech time overall due to manually entering results, but it helps ensure that antigen-negative units are available immediately and reduces delays from supplier orders.

Singher noted that the model doesn’t capture every nuance of day-to-day lab work, as staff discretion and existing inventory can influence whether units are typed in-house or ordered. Still, the findings suggest that routine in-house screening — especially when automated — may cut costs, streamline operations and make compatible RBCs more readily available for patients. It also allows labs to perform additional typing on pre-screened units, potentially saving time and resources.