What is the optimal adsorption method to remove an autoantibody in a patient reactive 2+ in the antiglobulin phase of testing?

Autoadsorption using the patient's ZZAP-treated red cells is recognized as the optimal method for removing an autoantibody in this scenario due to its effectiveness in breaking the bonds between antibodies and red cell antigens. ZZAP treatment, which involves the use of proteolytic enzymes such as papain and dithiothreitol (DTT) to treat red blood cells, modifies the red cell membranes by removing some surface proteins. This process helps to elute the autoantibodies present on the patient’s own red cells, allowing for a clearer separation of any alloantibodies and reducing interference in serological testing.

Using patient-derived ZZAP-treated red cells in autoadsorption specifically targets the autoantibodies present in the patient's serum, facilitating their removal while preserving reactivity towards non-self antigens. This method is preferred over others listed, as it capitalizes on the unique nature of the patient’s antibodies and employs modified cells directly from the individual in question.

Other methods, such as autoadsorption using LISS-treated red cells, might not effectively remove autoantibodies due to differences in how LISS modifies red cells compared to ZZAP. Likewise, using enzyme-treated red cells from normal donors or methyld