FDA 2011 guidance (I don't know what AABB last standards say about this) states "If ABO typing discrepancies exist, you should not rely on a computer crossmatch. This is particularly important if there is mixed field red cell reactivity, missing serum reactivity, or apparent change in blood type following hematopoietic stem cell transplantation. Under those circumstances, your procedures should provide for compatibility testing using serologic crossmatch techniques" ... But what if this discrepancy is easily explained by a recent non-isogroup transfusion... Would you still reject computer crossmatch? For what reason? How do you manage these situations in your lab?
When you have ABO typing discrepancies . First you resolve the ABO discrepancy than transfuse ABO compatible cells or plasma .
Hi German, some facilities will explain the mixed field reactivity with a footnote, or comment, (for documentation) when entering the reactions in the computer. It relies on the decision tables constructed in the validation plan/testing and accompanying SOPs. When a computer crossmatch is not deemed compatible from the inputs, some facilities will default to an immediate spin crossmatch or full indirect antiglobulin testing.
About the concept for resolving blood group discrepancy, we have to confirm it using tube method.it shows detail elaboration likelihood not possible using gel card.
It depends on what the results are in the computer. For example, if it's explainable and able to work around it to get results that look right (for example, an A patient has anti-M that is interfering in the backtype, you can run M neg A1 pos cells to get the appropriate negative reaction) you can still use electronic crossmatch.
However, if the result is explainable but not fixable, meaning the LIS will still have discrepant results in the blood type, you cannot issue electronic crossmatch blood. It will have to be a serological crossmatch. Many facilities will utilize the immediate spin crossmatch in this case, assuming the discrepancy is not due to a clinically significant antibody.
To manage ABO discrepancies working with Electronic/Computer Crossmatch, it is better to use AABB-approved computer software. According to Shy et al. 2019, the said software can electronically confirm and assess for ABO compatibility of both the donor and recipient.
(Reference: Shy, B. R., Tholpady, A., & Nedelcu, E. G. (2019). Interferences in blood bank testing. In Accurate Results in the Clinical Laboratory (pp. 425-437). Elsevier. DOI: 10.1016/B978-0-12-813776-5.00028-5)
- Badges
- Science topic
- Similar topics
- Filing