View Case

Back

Questions
Discussion
References

851) A 72-year-old female patient undergoing hip surgery has the type and screen results shown in Tables 1 and 2. Previous typing is consistent with these results and she has no history of a positive antibody screen. Two units of red blood cells (RBCs) are ordered before the start of surgery in case the surgeon encounters significant bleeding. Assuming all crossmatching methods are technically possible at this hospital, which of the following would be the most appropriate and efficient crossmatch to perform before release of the units?

Front Type Back Type RhD Typing

anti-A anti-B A1 cells B cells Rh

4+ 4+ 0 0 2+

Antibody Screen Test Method

D C c E e K k Jk^a Jk^b Fy^a Fy^b M N S s Le^a Le^b Anti-human Globulin Check Cells

Cell I + + 0 0 + + + + 0 + 0 0 + 0 + + 0 0 2+

Cell II + 0 + + 0 0 + 0 + + + + + + + 0 + 0 2+

Front Type	Back Type	RhD Typing
4+	4+	0	0	2+

Antibody Screen	Test Method
Cell I	+	+	0	0	+	+	+	+	0	+	0	0	+	0	+	+	0	0	2+
Cell II	+	0	+	+	0	0	+	0	+	+	+	+	+	+	+	0	+	0	2+

No crossmatch is necessary; any two units may be released. Electronic crossmatch. Immediate spin crossmatch. Full anti-human globulin (AHG) crossmatch in tube. Full AHG crossmatch in solid phase.

Show Diagnosis/Topic

• A crossmatch must be performed unless emergency release red cell units are requested.

• An immediate spin crossmatch can be used as the sole crossmatching method only if the patient has a negative antibody screen and no history of red cell antibodies.

• An immediate spin crossmatch is used to ensure the absence of ABO incompatibility.

• A full crossmatch should include a 37°C incubation of a sample of red cells from the attached segment of the unit to be transfused, the patient’s serum or plasma, and the addition of antihuman globulin (AHG). This can be performed using tube testing, column agglutination, or solid-phase systems.

• For patients with a positive antibody screen (either historically or currently) or an alloantibody to a low-prevalence antigen, the full crossmatch will prevent transfusion of incompatible red cells not identified in red cell antibody testing due to the low prevalence of the incompatible antigen.

Back

Antibody Screen																		Test Method
	D	C	c	E	e	K	k	Jk^a	Jk^b	Fy^a	Fy^b	M	N	S	s	Le^a	Le^b	Anti-human Globulin	Check Cells
Cell I	+	+	0	0	+	+	+	+	0	+	0	0	+	0	+	+	0	0	2+
Cell II	+	0	+	+	0	0	+	0	+	+	+	+	+	+	+	0	+	0	2+

Clinical Pathology: General Principles, Hematology & Coagulation, Transfusion Medicine

View Notes

Add a Note