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Journal of veterinary internal medicine2020; 34(2); 941-948; doi: 10.1111/jvim.15710

Agreement of stall-side and laboratory major crossmatch tests with the reference standard method in horses.

Abstract: Crossmatching is used to prevent life-threatening transfusion reactions in horses. Laboratory methods are laborious and technically challenging, which is impractical during emergencies. Objective: Evaluate agreement between a stall-side crossmatch kit (KIT) and a laboratory method (LAB) in horses with known and unknown blood types. Methods: Twenty-four blood-typed and alloantibody-screened healthy adult horses (Aim 1) and 156 adult horses of unknown blood type (Aim 2). Methods: Prospective, blinded study. Expected positive (n = 35) and negative (n = 36) crossmatches among 24 antibody and blood-typed horses were used to determine sensitivity and specificity of KIT and LAB against the reference method. Agreement in 156 untyped horses was evaluated by reciprocal crossmatch (n = 156). Results: Sensitivity (95% confidence interval [CI]) for LAB and KIT compared with expected reactions was 77.1% (59.9%-90.0%) and 91.4% (77.0%-98.2%), and specificity 77.8% (60.9%-89.9%) and 73.5% (55.6%-87.1%), respectively. The KIT was 100% sensitive for Aa reactions; LAB was 100% sensitive for Qab; and both were 100% sensitive for Ca. Cohen's κ agreement for LAB and KIT with expected positive and negative reactions (n = 71) was moderate (0.55 [0.36-0.74]) and substantial (0.65 [0.47-0.82]), respectively. Agreement was fair comparing LAB with KIT in Aim 1 (0.30 [0.08-0.52]) and in untyped horses in Aim 2 (0.26 [0.11-0.41]). Conclusions: Agreement between KIT and LAB with expected reactions was blood type dependent. Performance of both methods depends on blood type prevalence.
© 2020 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.
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Publication Date: 2020-02-04 PubMed ID: 32017276PubMed Central: PMC7096648DOI: 10.1111/jvim.15710Google Scholar: Lookup
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Summary

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The research article discusses the comparison between the agreement of a stall-side crossmatch kit (KIT) and a laboratory method (LAB) against a standard method to prevent life-threatening transfusion reactions in horses. The study includes results derived from blood-typed and alloantibody-screened healthy adult horses as well as adult horses with unknown blood types.

Objective and Methodology

  • The objective of the study was to evaluate the agreement between a stall-side crossmatch kit (KIT) and a laboratory method (LAB) in horses with known and unknown blood types. An important goal was to find a convenient and quick method to crossmatch horse’s blood during emergencies.
  • The study was conducted enrolling 24 blood-typed and alloantibody-screened healthy adult horses and 156 adult horses of unknown blood type. Specifically, the study included two aims:
    • Aim 1: Involves 24 blood-typed and alloantibody-screened healthy adult horses used to compare the results with known blood groups and antibodies.
    • Aim 2: Involves 156 adult horses of unknown blood type to analyze the efficiency of the laboratory method and the kit in detecting unknown blood groups and antibodies.
  • The expected positive and negative crossmatches among the 24 antibody and blood-typed horses were used to determine the sensitivity and specificity of both KIT and LAB against the standard method.
  • The agreement in 156 untyped horses was evaluated by reciprocal crossmatch.

Results and Inferences

  • The result of the study demonstrated that the sensitivity and specificity of both KIT and LAB differ. The laboratory method had a sensitivity of 77.1%, and the kit had a sensitivity of 91.4%. The specificity results showed the laboratory method at 77.8% and the kit at 73.5%.
  • It was observed that the kit was 100% sensitive for Aa reactions. Similarly, the laboratory method showed 100% sensitivity for Qab reactions, both KIT and LAB were 100% sensitive for Ca.
  • Additionally, the Cohen’s κ agreement for LAB and KIT with expected positive and negative reactions was moderate and substantial, respectively. However, the agreement between LAB and KIT considered fair in both Aim 1 (24 blood-typed horses) and Aim 2 (156 untyped horses).

Conclusion

  • The study concludes that the agreement between the KIT and LAB with the expected reactions was dependent on the blood type.
  • The performance of both methods was observed to be blood type prevalence dependent.

Cite This Article

APA
Fenn MS, Bortsie-Aryee AD, Perkins GA, Mann S, Tomlinson JE, Wood EM, Mix SE, Stokol T. (2020). Agreement of stall-side and laboratory major crossmatch tests with the reference standard method in horses. J Vet Intern Med, 34(2), 941-948. https://doi.org/10.1111/jvim.15710

Publication

Journal of veterinary internal medicine
ISSN: 1939-1676
NlmUniqueID: 8708660
Country: United States
Language: English
Volume: 34
Issue: 2
Pages: 941-948

Researcher Affiliations

Fenn, Melissa S
  • Cornell University, Department of Clinical Sciences, College of Veterinary Medicine, Ithaca, New York.
Bortsie-Aryee, Araba D
  • Cornell University, Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Ithaca, New York.
Perkins, Gillian A
  • Cornell University, Department of Clinical Sciences, College of Veterinary Medicine, Ithaca, New York.
Mann, Sabine
  • Cornell University, Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Ithaca, New York.
Tomlinson, Joy E
  • Cornell University, Baker Institute for Animal Health, College of Veterinary Medicine, Ithaca, New York.
Wood, Emma M
  • Cornell University, Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Ithaca, New York.
Mix, Susan E
  • Cornell University, Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Ithaca, New York.
Stokol, Tracy
  • Cornell University, Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Ithaca, New York.

MeSH Terms

  • Animal Husbandry
  • Animals
  • Blood Grouping and Crossmatching / veterinary
  • Blood Transfusion / veterinary
  • Female
  • Horses / blood
  • Male
  • Point-of-Care Systems
  • Prospective Studies
  • Sensitivity and Specificity

Grant Funding

  • Harry M. Zweig Memorial Fund for Equine Research

Conflict of Interest Statement

Authors declare no conflict of interest.

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Citations

This article has been cited 4 times.
  1. Kakoi H, Kikuchi M, Ishige T, Hirosawa Y, Tanaka S, Nagata SI. Monitoring the positive conversion of anti-erythrocyte antibodies in blood transfusion donor horses. J Equine Sci 2023 Jun;34(2):47-49.
    doi: 10.1294/jes.34.47pubmed: 37405070google scholar: lookup
  2. Jamieson CA, Baillie SL, Johnson JP. Blood Transfusion in Equids-A Practical Approach and Review. Animals (Basel) 2022 Aug 23;12(17).
    doi: 10.3390/ani12172162pubmed: 36077883google scholar: lookup
  3. Kakoi H, Kikuchi M, Ishige T, Nagata SI, Hirosawa Y, Tanaka S, Kishinami T. Investigation of erythrocyte antigen frequencies in draft horse populations in Japan to assess blood donor suitability. J Equine Sci 2021 Mar;32(1):17-19.
    doi: 10.1294/jes.32.17pubmed: 33776536google scholar: lookup
  4. Proverbio D, Perego R, Baggiani L, Ferrucci F, Zucca E, Nobile F, Spada E. Prevalence of Ca Blood Type and Alloantibodies in a Population of Horses from Italy. Animals (Basel) 2020 Jul 13;10(7).
    doi: 10.3390/ani10071179pubmed: 32668596google scholar: lookup
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