Management of Blood Components with Positive Direct Antiglobulin Test Results

Direct antiglobulin test (DAT)-positive red blood cell components have been increasingly detected in hospital transfusion services.These units may cause crossmatch incompatibility and lead to the disposal of blood components.DAT positivity is occasionally observed in healthy individuals and blood donors, with variable reported frequencies.Most DAT-positive donors are asymptomatic, but persistently or strongly positive IgG DAT results may be associated with drug exposure, autoimmune disease, hemolysis, or other clinical conditions.Instead of discarding DAT-positive blood products, conditional usage should be considered based on the test results and transfusion circumstances.Management of DAT-positive blood components requires a risk-based approach that distinguishes IgG from complement-only reactivity and considers the persistence and strength of DAT positivity.In Korea, it is required to establish guidelines for reporting systems between hospital blood banks and blood suppliers, donor follow-up criteria, and the possible conditional usage of DAT-positive blood components.(Korean