<p>Methods for accurate, rapid blood typing and antibody titration at the point of care are constrained by cold-chain dependent red blood cell (RBC) reagents, time-consuming serial dilutions, and subjective visual interpretation. To overcome these limitations, here we develop a method based on bioengineered red-blood cells. We engineer hemoglobin-depleted RBC membranes that preserve ABO surface antigens, label them with fluorescent nanoparticles, and lyophilize them, demonstrating at least 2 years of stability at room-temperature. We capture hemagglutination on a dual-layer paper pad and quantify it by fluorescence in approximately 8 minutes, eliminating the need for serial dilution. We conduct a registered clinical trial (ChiCTR2300078864) and benchmark performance against the gel microcolumn assay. In a clinical cohort (n = 641), ABO typing achieves 100% concordance. In antibody-titration samples, quantitative titers agree with the gel microcolumn assay (coincidence 80.75%, κ = 0.8623). In summary, we develop a cold-chain-independent, handheld paper-based assay that enables simultaneous ABO grouping and quantitative antibody titration with clinical-grade performance, supporting scalable manufacturing, cross-site standardization, and transfusion decision-making in emergency and resource-limited settings.</p>

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Paper-based fluorescent assay for blood typing and antibody titer determination using long-term ambient-stored bioengineered RBCs

  • Yuxuan Li,
  • Yulong Zhang,
  • Shengqiang Liang,
  • Daye Cao,
  • Weifeng Ye,
  • Zebin Hu,
  • Jindian Xie,
  • Qinan Ban,
  • Xiaoqin Zhou,
  • Chengzi Quan,
  • Sujing Sun,
  • Man Zhao,
  • Xiaowen Xing,
  • Qianqian Zhou,
  • Jiawei Bai,
  • Linsheng Zhan,
  • Daming Wang,
  • Xiaohui Wang

摘要

Methods for accurate, rapid blood typing and antibody titration at the point of care are constrained by cold-chain dependent red blood cell (RBC) reagents, time-consuming serial dilutions, and subjective visual interpretation. To overcome these limitations, here we develop a method based on bioengineered red-blood cells. We engineer hemoglobin-depleted RBC membranes that preserve ABO surface antigens, label them with fluorescent nanoparticles, and lyophilize them, demonstrating at least 2 years of stability at room-temperature. We capture hemagglutination on a dual-layer paper pad and quantify it by fluorescence in approximately 8 minutes, eliminating the need for serial dilution. We conduct a registered clinical trial (ChiCTR2300078864) and benchmark performance against the gel microcolumn assay. In a clinical cohort (n = 641), ABO typing achieves 100% concordance. In antibody-titration samples, quantitative titers agree with the gel microcolumn assay (coincidence 80.75%, κ = 0.8623). In summary, we develop a cold-chain-independent, handheld paper-based assay that enables simultaneous ABO grouping and quantitative antibody titration with clinical-grade performance, supporting scalable manufacturing, cross-site standardization, and transfusion decision-making in emergency and resource-limited settings.