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Thimerosal dependent agglutination, a newly described blood bank problem

A number of ABO grouping, Rh typing, antibody screening, and antibody identification problems are associated with chemicals in blood bank reagents. We describe a newly discovered agglutination phenomenon due to a thimerosal (Merthiolate)‐dependent agglutinin found in the serum of a normal blood donor. Thimerosal is used as a preservative in several low‐ionic strength reagents. This agglutination phenomenon is detected only in test systems (low‐ionic‐strength, albumin, saline, ficin treated test cells) in which test cells are incubated in the presence of thimerosal. Agglutination does not occur in the absence of thimerosal. The thimerosal‐dependent agglutinin behaves like an IgG IgG autoantibody. There is no evidence that the thimerosal‐dependent agglutinin is responsible for increased red cell destruction.