Crossmatching Flashcards
Before issue, what sample is crossmatched against what is this other sample?
Recipient’s serum/plasma is crossmatched against donor cells from an integrally attached whole blood or RBC segment and uses AHG test
What does the crossmatch demonstrate?
- ABO incompatibility (IAT)
- Clinically significant antibodies
What are the 2 determinations of a recipient’s blood type?
- Current sample
- Separately collected sample or historical record or current sample repeated
If blood is O neg, what do you retype with to prove ABO correct labeling?
- anti-A,B
- anti-D
Most common cause of HTR
ABO mislabel
When to perform AHG crossmatch
- previous antibody history
- current antibody in plasma (known or unknown)
- new workup every 72 hours
Additional caveats to “complete workup is ok for 72 hrs”
- additional units need crossmatch
- crossmatch must be performed in same way
Additional caveats to “negative workups require less work”
- negative antibody screen = ABO match only (required 80% of time)
- computer logic may replace serological work
Exceptions to “before issue” crossmatch”
- emergency (give O neg)
- neonate (no crossmatch if less than 4 mths old)
- massive transfusion
- discrepancy
- must resolve missed crossmatch eventually
Inventory availability affected by
- donor population frequency
- expiration dates
- balance the needs of all patients (urgency of request)
When to do serological crossmatch
No previous blood type on record (do immediate spin and/or extended/Coombs)
When to do electronic crossmatch
- Utilized when 2 determinations of recipient blood type match
- must have negative screen + unit retype
When can you not perform electronic crossmatch?
- patient has positive antibody screen
- history of positive antibody screen
Pretransfusion steps for RBC transfusion
- Physician orders blood transfusion
- Collect blood sample in EDTA tube
- Perform blood type
- Ab screen
- Select appropriate blood product
- Red cell must have its ABO unit retype performed
- Crossmatch the donor product with patient plasma
- Label the donor component w a crossmatch/compatibility tag (2 pt IDs)
What to do at time of blood transfusion issue
- Read-back with courier who picks up product (check 2 pt ID, blood types, unit expiration, compatibility)
- Visually inspect unit
