Prospective evaluation of the utility of cross‐matching prior to first transfusion in cats: 101 cases

Abstract

Objectives: To: (1) assess the frequency of crossmatch incompatibility in naïve feline blood transfusion recipients using two crossmatching methods, (2) measure the effect of crossmatch incompatibility on change in packed cell volume following transfusion, (3) assess the frequency of acute transfusion reactions and errors in blood transfusions in cats and (4) assess the impact of crossmatch incompatibility on the likelihood of transfusion reactions. Materials and MethOds:Cats being administered a first AB-matched transfusion in a veterinary teaching hospital were prospectively recruited for this observational study. A slide agglutination method and a commercial test were both used for major and minor crossmatching. We measured increase in packed cell volume at 12 hours after transfusion relative to the mass of red blood cells given per recipient bodyweight and recorded transfusion reactions.results: A total of 101 cats was included. Crossmatch incompatibility was common using the slide agglutination method (27% and 10% major and minor incompatibility, respectively), but less common with the commercial test (major and minor incompatibility both 4%). Crossmatch incompatibility with any method was not associated with less effective transfusion in terms of change in packed cell volume. Transfusion reactions occurred in 20 cats, most commonly febrile non-haemolytic transfusion reactions (n = 9) and haemolytic transfusion reactions (n = 7). The commercial test appeared to be most specific for predicting haemolytic transfusion reactions.clinical significance: Transfusion reactions were fairly common but not associated with increased mortality. Use of crossmatch-compatible blood did not lead to a greater increase in PCV at 12 hours.The commercial test may predict a haemolytic transfusion reaction.

Identification of 5 novel feline erythrocyte antigens based on the presence of naturally occurring alloantibodies

“…Previous reports have already documented crossmatch incompatibilities and transfusion reactions in AB‐matched transfusion naïve cats, highlighting the presence of NOAb outside of the AB system 15‐22 . Our study supports the presence of non‐AB NOAb with 3.9% chance of detecting incompatibilities by randomly crossmatching 2 cats, which resulted in at least 7% of 258 type A cats having NOAb.…”

“…Previous reports have already documented crossmatch incompatibilities and transfusion reactions in AB-matched transfusion naïve cats, highlighting the presence of NOAb outside of the AB system. [15][16][17][18][19][20][21][22] Our study supports the presence of non-AB NOAb with 3.9% chance of detecting incompatibilities by randomly crossmatching test and commercial gel-tube assay. 1 We chose to use the saline gel column technique because this method has been proven to be highly accurate in human medicine with a sensitivity between 97.58% and 100% and a specificity close to 100%.…”

“…Only 1 study compared transfusion events between cats with pretransfusion compatible crossmatch and cats with pretransfusion incompatible crossmatch. In this study, detection of incompatibilities by a bedside commercial kit, but not by a laboratory method, appeared to be associated with the development of hemolytic transfusion reactions 22 . With at least 7% of cats presenting NOAb, almost 2% of them having incompatibilities to all RBC to which they were tested, conflicting results in recent studies, and previous documentation of acute hemolytic transfusion reactions caused by non‐AB NOAb (anti‐ Mik ), crossmatching cats before a first transfusion remains valid cautionary recommendation as long as the clinical importance of NOAb and crossmatch incompatibility is not better characterized 15 …”

“…15,19 However, a prospective observational study of 101 cats showed marked difference in the proportion of crossmatch incompatibility between the laboratory method (27%) and a commercial gel tube test (4%). 22 In a study comparing a saline gel col- It should also be noted that there is a lack of standardization of grade at which gel column crossmatch results are considered incompatible in veterinary medicine, with some studies using the grade 1+…”

Effect of dilution of canine blood samples on the specificity of saline agglutination tests for immune‐mediated hemolysis

“…Investigation of a larger number of IMHA cases is needed before concluding that small aggregates of erythrocytes are not evidence of agglutination, but our results suggest that until such studies becomes available, weak positive SATs should be confirmed by DAT. This should not be extrapolated to interpretation of pretransfusion slide-based crossmatches,27,28 as in this setting,…”