Compatibility For Blood Transfusion Flashcards
What is involved in compatibility testing?
All steps in ID and testing of donor unit and a proposed recipient’s blood
Crossmatching is…?
Part of compatibility testing
What is involved in compatibility testing? Testing wise
Involves mixing donor RBCs and recipient serum or plasma
What indicates incompatibility in compatibility testing?
Agglutination or hemolysis
What indicates compatibility in compatibility testing?
No agglutination or hemolysis
What is the purpose of cross matching the patient with donor?
- Serves as a double check of ABO errors
- A second means of detecting antibodies
AABB standards for compatibility cross matching involves
- Demonstrate ABO compatibility or incompatibility
- Show presence or absent of significant antibodies to RBC antigens
- Must have AHG phase
What are the criterias for an IS cross match to be done?
When recipient has no evidence of an antibody in current sample or historical record
Whats another reason for IS crossmatch besides patient compatibility?
Fulfills AABB standards for detecting ABO incompatibility.
What is done in IS crossmatch?
Recipient serum and donor RBC suspensions are mixed and immediately centrifuged
What are the criterias for an extended crossmatch to be done?
- All phases (IS, 37C, AHG) are performed if patient demonstrates clinically significant antibody in current sample or in historical record.
A patient’s sample has an autoantibody in extended crossmatch. What is done next after all the phases?
Patient has autoantibody so autoadsorbed serum can be used
What are the reasons for a positive in serologic crossmatch?
- Incorrect ABO grouping of patient or donor
- Alloantibody in patient’s serum reacting with antigen on donor RBCs
- Autoantibody in patient’s serum reacting with antigen on donor RBCs
- New alloantibody
- Alloantibody to low - incidence
- Warm-reactive autoantibody
- Donor positive DAT
What is computer crossmatching?
Makes a final check of the ABO compatibility in the selection of units instead of a serologic IS procedure. The barcodes add another measure of safety.
For computer crossmatching look for in potential matches?
Recipient must not have an antibody or antibodies in the current sample or have a history of antibodies.
What are limitations with a transfusion?
- Acceptable crossmatch does not guarantee successful transfusion
- Adverse transfusion rxn may still occur
- Negative antibody screen does not guarantee recipient does not have significant antibodies.
- A compatible crossmatch does not guarantee survival of RBCs.
A properly performed pretransfusion will?
- Verify ABO compatiblility (in most cases)
- Detect most clinically significant unexpected antibodies
True or false, blood is not a drug and doesn’t require a physician prescription.
False, blood is considered a drug therefore a prescription is required.
What are ways a transfusion form can be made?
Orally, electronically, or written. It must include sufficent information to positively ID patient. If not reject and contact nurse / physician
What are some identifiers that can be used?
- Patient full name
- Unique ID number
- DOB
- Driver’s license number
- Photographic ID
What is the minimum number of identifiers needed?
At least 2
Can a transfusion request be rejected if the handwriting is illegible?
Yes
What are some reasons for a transfusion request form to be rejected?
- Info incomplete or lacking
- Inaccurate
- Illegible
General Blood bank specimens are stable for how long?
Expires on 3rd day at midnight
Neonate specimens are stable for how long?
4 months of age. They are given type O RBCs
Elective surgery patient specimens are stable for how long?
Up to 30 days prior to surgery
What are restrictions with elective surgery patient specimens?
- No history of alloantibodies
- No history of pregnancy or transfusion within last 3 months
- Negative antibody screen
Where are blood specimen specimens labeled?
At patient bedside
What information must be on a blood specimen for blood bank?
- Full name
- Unique ID number
- Date of collection
- Time of collection
- Phlebotomist ID
What types of specimen can be in the collection tubes?
Plasma or serum
What kind of samples are rejected and put in for recollection?
- Hemolyzed samples
- Samples contaminated with IV fluids
What is the temperature specimens are stored at?
1C - 6C
How long are specimens kept for after transfusion?
7 Days
When is ABO and D typing repeated for a patient?
If previous results are over past 12 months old
What is used to confirm ABO / RH if there is no history?
A second sample is used
What can be done to eliminate a need for a second sample when results are over a year old?
PPID
Previous records must be consulted when there is…?
Any significant event related to testing or transfusion
In pretransfusion testing, a type and screen does what?
It will detect 99.9% of unexpected antibodies.
1. Resolve or help resolve discrepancies before transfusion
2. If unpooled reagent RBCs used it should help with antibody detection
In pretransfusion testing a crossmatching…
Demonstrates ABO incompatibility and clinically significant antibodies to RBC antigens
