Do patients with autoantibodies or clinically insignificant alloantibodies require an indirect antiglobulin test crossmatch?

Lee, Edmond; Redman, Martin; Burgess, Gordon; Win, Nay

doi:10.1111/j.1537-2995.2007.01272.x

Cited by 8 publications

(6 citation statements)

References 27 publications

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“…At least one report demonstrated a benefit to modifying XM requirements. Lee and coworkers demonstrated that no additional benefit was achieved by performing a serologic (IgG) XM over an immediate spin (IS) XM to confirm ABO compatibility; these authors propose that, in the AIHA patient population, once alloantibodies are excluded, limiting XM testing to an IS XM can decrease turn‐around time and cost without compromising patient safety …”

Section: Resultsmentioning

confidence: 99%

Warm‐reactive (immunoglobulin G) autoantibodies and laboratory testing best practices: review of the literature and survey of current practice

et al. 2016

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Section: Resultsmentioning

confidence: 99%

Warm‐reactive (immunoglobulin G) autoantibodies and laboratory testing best practices: review of the literature and survey of current practice

et al. 2016

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“…TS policy with IS crossmatch (Policy B) is as safe as TS policy with conventional AHG crossmatch (Policy A), and this has been proven multiple times by various authors. [ 2 3 4 5 6 7 8 9 10 11 ] Present authors have also published on safety of TS policy with IS crossmatch. [ 15 ] The authors would wish to discuss other advantages of this policy with respect to decreased C/T ratio, decreased issue TAT, decreased outdating of RBC units, man-hours consumption, and monetary savings.…”

Section: Discussionmentioning

confidence: 99%

“…In comparison, TS policy with immediate-spin (IS) crossmatch provides similar immunohematological safety[ 2 3 4 5 6 7 8 9 10 11 ] with possibility of better crossmatch-to-transfusion (C/T) ratio and decreased turnaround time (TAT) for the issue of blood units. Since there is no reservation of RBC units in the TS policy and RBCs are cross-matched and issued as and when required by the patient, outdating of RBC units decreases.…”

Section: Introductionmentioning

confidence: 99%

Advantages of type and screen policy: Perspective from a developing country!

Aggarwal

Tiwari

Arora

et al. 2018

Asian J Transfus Sci

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INTRODUCTION:The authors' center recently changed their pretransfusion testing protocol from “conventional” type and screen (TS) with anti-human globulin (AHG) crossmatch (Policy A) to TS with immediate-spin (IS) crossmatch (Policy B). Red blood cell (RBC) units were issued after compatible IS crossmatch as and when required instead of AHG crossmatch. This study was conducted to compare the effects of change of policy from A to B over 1-year period on crossmatch-to-transfusion (C/T) ratio, RBC issue turnaround time (TAT), outdating of RBC, man-hours consumption, and monetary savings.MATERIALS AND METHODS:This was a comparative, prospective study conducted by the Department of Transfusion Medicine of a tertiary hospital-based blood bank in Northern India. The Policy B was implemented in the department from January 2014. Relevant retrospective data for comparison of the previous 1 year, when Policy A was practiced, were derived from hospital information system.RESULTS:23909 and 24724 RBC units transfused to patients admitted to the hospital during respective 1-year period of practice for Policy A and B. There was significant reduction in C/T ratio (1.94 vs. 1.01) and RBC issue TAT (79 vs. 65 min) with Policy B. Expiry due to outdating reduced (37 vs. zero) along with man-hours (16% reduction) and monetary (33% reduction) savings.CONCLUSION:Use of 'TS with IS crossmatch' policy provides multiple advantages to all the stakeholders; blood banker, clinician, patient, and the hospital management.

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“…A low number of IgG molecules are usually bound to the surface of all red cells [25] and even transfusion of RBCs to patients with autoimmune‐haemolytic anaemia with circulating autoantibodies usually does not cause haemolytic transfusion reactions. This has been systematically evaluated in 325 patients with free RBC autoantibodies and a positive XM, who received more than 1300 RBC units [26].…”

Section: Discussionmentioning

confidence: 99%

Coombs’ crossmatch after negative antibody screening - a retrospective observational study comparing the tube test and the microcolumn technology

Lange¹,

Selleng²,

Heddle

et al. 2010

Vox Sanguinis

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Background The antiglobulin crossmatch (AHG XM) is mandatory in Germany and Austria for all patients scheduled for red blood cell (RBC) transfusions. We assessed how many biological relevant RBC alloantibodies are identified by the AHG XM in patients with negative antibody screen (ABS), comparing two screening methods: the conventional tube test (CTT) and the microcolumn technology (MCT). Materials and MethodsAll AHG XMs performed in the Department of Transfusion Medicine, University Greifswald, were retrospectively analysed for an eight year period. Data source included test results for ABS, AHG XMs and antibody identification. The study period consisted of three parts: (1) 2-cell ABS and XM by CTT; (2) 2-cell ABS and XM by MCT; (3) 3-cells ABS and XM by MCT.Results A total of 312 275 AHG XMs were assessed: 105 647 CTT and 206 628 MCT (after 2-cell ABS: 80 295 and after 3-cell ABS 126 333). There was a fivefold increase in reactive AHG XMs using MCT compared to CTT XMs (0AE25% vs. 0AE05% respectively; P < 0AE001). Excluding anti-A 1 , other RBC alloantibodies were found with a very low frequency regardless of the method used [CTT 5 ⁄ 105 647 (0AE005%), MCT 3 ⁄ 80 295 + 2 ⁄ 126 333 (0AE002%); P = 0AE3]. RBC alloantibodies were identified in only 1% of the reactive MCT XMs. The two RBC alloantibodies identified after 3-cell ABS were of minor clinical relevance (anti-P 1 , anti-M).Conclusion When an AHG XM becomes reactive after negative ABS result, this is caused with very few exceptions by clinically irrelevant reactivities. This especially accounts for reactive AHG XM using the MCT.

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Do patients with autoantibodies or clinically insignificant alloantibodies require an indirect antiglobulin test crossmatch?

Cited by 8 publications

References 27 publications

Warm‐reactive (immunoglobulin G) autoantibodies and laboratory testing best practices: review of the literature and survey of current practice

Warm‐reactive (immunoglobulin G) autoantibodies and laboratory testing best practices: review of the literature and survey of current practice

Advantages of type and screen policy: Perspective from a developing country!

Coombs’ crossmatch after negative antibody screening - a retrospective observational study comparing the tube test and the microcolumn technology

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