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

• 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.

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