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Yves Bikorimana: Before Wash vs After Wash in Blood Grouping
Feb 20, 2026, 14:20

Yves Bikorimana: Before Wash vs After Wash in Blood Grouping

Yves Bikorimana, CEO at MedData-Rwanda and Lab Scientist at The University  Teaching Hospital of Kigali-Chuk, shared a post on LinkedIn:

“Before Wash vs After Wash in Blood Grouping – Why It Matters

In immunohematology, small technical details can completely change interpretation. This image perfectly demonstrates the importance of the saline wash step during blood grouping and antibody testing.

Let’s break it down

Left Side: Tube Method (Cell Washing)

Before Wash

We see a red cell suspension with plasma and possible interfering substances still present. Proteins, rouleaux formation, or excess antibodies can create pseudo-agglutination or mask true reactions.

After 3× Saline Wash plus Centrifugation

The supernatant becomes clear, and only packed red cells remain at the bottom.

Why is this important?

  • Removes unbound antibodies
  • Eliminates excess plasma proteins
  • Prevents false reactions
  • Improves accuracy of antiglobulin testing

Washing ensures we are detecting true antigen–antibody reactions, not artifacts.

Right Side: Slide/Card Agglutination (Anti-A, Anti-B, Anti-D)

Before Wash

Anti-D appears weakly positive — but note the label: False agglutination.

Sometimes:

  • Rouleaux formation
  • Fibrin strands
  • High protein states
  • Improper cell suspension

can mimic agglutination.

After Wash

The false Anti-D reaction disappears.

Result interpretation becomes clear and reliable.

  • Anti-A: Negative
  • Anti-B: Negative
  • Anti-D: Negative

Final Blood Group: O Rh(D) Negative

Key Takeaway

In transfusion medicine, accuracy is patient safety.

A simple saline wash step can:

  • Prevent mislabeling of blood groups
  • Avoid incompatible transfusions
  • Reduce risk of hemolytic transfusion reactions

In laboratory science, precision isn’t optional — it’s ethical responsibility.”

Yves Bikorimana: Before Wash vs After Wash in Blood Grouping

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