Revisiting the issue: can the reading for serologic reactivity following 37°C incubation be omitted?

Abstract

Eliminating the 37 degrees C reading from pretransfusion antibody screening tests imposes less risk than omitting the routine IAT-XM, and it avoids the time and costs of evaluating unwanted positive tests, thus reducing expenditures and delays in patient care.

Red blood cell-incompatible allogeneic hematopoietic progenitor cell transplantation

“…Further investigation of positive antibody screens for either the donor or recipient should be performed to determine donor-patient red cell compatibility before transplantation, and patient records reviewed for a history of red cell antibodies. Routine donor-recipient serological crossmatch testing for most healthy donors is unlikely to improve patient safety, [126][127][128] but each transplant program should establish policies regarding the appropriate testing of the donor-recipient pair. The transplant program requesting blood components must have a mechanism alerting the transfusion service of the need to use components that would not be first choice in the nontransplant setting, but that may be critical for the patient undergoing HPC transplantation.…”

How I manage cold agglutinins

“…In these regards, polyethylene glycol or gel techniques 2,3 are ideal methods to use. Data supporting safety of the above recommendations are found in Trudeau and colleagues, 4 Laferriere and coworkers, 5 Judd and colleagues, 6‐8 and Judd 9…”

“…Use of anti-IgG instead of polyspecific antiglobulin reagent.In these regards, polyethylene glycol or gel techniques 2,3 are ideal methods to use. Data supporting safety of the above recommendations are found in Trudeau and colleagues, 4 Laferriere and coworkers, 5 Judd and colleagues, [6][7][8] The one problem that can arise from omitting readings for direct agglutination when screening for unexpected antibodies is the occurrence of a positive immediate-spin cross-match when the screening tests are negative. In this situation, before implementing an electronic cross-match, our approach was to verify that blood of the correct ABO type had been selected and to crossmatch the units by the indirect anitglobulin test (IAT).…”

Rapid laboratory testing for trauma patients: where a perfect result may not be in the best interests of the patient

“…Long gone are the days of the minor antiglobulin crossmatch and the routine use of elaborate enhancement additives and room temperature or 37°C readings are fading from use; for more and more patients the AHG crossmatch has been replaced by the immediate spin or electronic crossmatch 3 . Undoubtedly, some clinically important antibodies go undetected, 4,5 but these occasions are rare and are surely outweighed by the benefit of providing blood products quickly without having to forgo compatibility testing altogether.…”