INTRODUCTIONPre-transfusion compatibility testing is crucial to the transfusion process. Before red blood cell (RBC) transfusion, blood samples from donors and recipients are analyzed to determine their ABO and RhD blood typing, to look for unexpected RBC alloantibodies, and to con rm cross-match compatibility [1]. These tests are crucial for preventing transfusion of incompatible donor red cells that might cause a hemolytic reaction.Manual immunohematology testing has been performed by centrifuging RBCs and antibodies in test tubes, followed by a visual determination of the extent of RBC agglutination. Although the manual method is still considered the gold standard, this technique has inherent limitations. These include the elution of low af nity antibodies during washing, the variability in results due to differences in the cell-serum ratio, and the inconsistency in reporting due to inter-observer variability Background: An automated immunohematology analyzer, DAYMATE M (DAY Medical, Switzerland), has been recently developed. The potential of this analyzer to improve test results has been evaluated. Methods: A total of 300 blood samples from Seoul St. Mary's hospital and Incheon St. Mary's hospital were tested for ABO and RhD typing. In addition, 336 antibody screening test (AST) samples and 82 patients treated with hematopoietic stem cell transplantation (HSCT) were included. AST results by DAYMATE M were compared with those obtained by a manual method using DS-Screening II (Bio-Rad Laboratories, Switzerland) and red blood cells from Selectogen (Ortho-Clinical diagnostics Inc., USA). Results: Of the 300 patients enrolled, 87, 73, 79, and 61 had type A, B, O, and AB blood, respectively. The concordance rate was 99.9% for cell typing and 97.0% for serum typing. One discordant case was classified as type B instead of AB, and six discordant serum-typing cases were type A, but classified as type AB. Among the 336 AST samples, the concordance rate was 93.2%. From 136 positive cases, six were discordant. Within the 82 HSCT-treated patients, the concordance rate for ABO blood typing was 92.2%. Among the six discordant cases, DAYMATE M typed four cases as donor type where the standard method typed them as the recipient blood type. Conclusions: The DAYMATE M automated immunohematology analyzer performs reliably for ABO and RhD typing, as well as for ASTs and on samples from patients treated with HSCT.