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CROSSMATCHING TECHNIQUES

CROSSMATCHING TESTING

Cross matching

The AABB and FDA develop the standards for blood banking

According to the AABB Standards:

The crossmatch “shall use methods that demonstrate ABO incompatibility and clinically significant antibodies to red cell antigens and shall include an antiglobulin phase”

Purpose:

  • Prevent transfusion reactions
  • Increase in vivo survival of red cells
  • Double checks for ABO errors
  • Another method of detecting antibodies

Types of Cross matching

  • Major – routinely performed in labs
  • Minor – not required by AABB since 1976

Crossmatches...

MAJOR VS MINOR CROSSMATCHING

Will

Verify donor cell ABO compatibility

Detect most antibodies against donor cells

Will Not

Guarantee normal survival of RBCs

Prevent patient from developing an antibody

Detect all antibodies

Prevent delayed transfusion reactions

Detect ABO/Rh errors

PROCEDURE

Submitted to:

Dr. Atibagos

Sir. Fritz Gonazaga

Submitted by:

Quinn Everette N. Ramirez

Kimberly D. Ramos

Arielle Mae M. Saim

Lara Maica Salem

Joriza Marie Angeline D.R Sanchez

MICO 43

METHOD FOR MAJOR CROSSMATCH

Computer Crossmatch

The electronic crossmatch according to the AABB, the following must be fulfilled:

  • Critical elements of the information system have been validated on-site.
  • No clinically significant antibodies are detected in the current blood sample and there is no record of clinically significant antibodies in the past

ANTIGLOBULIN CROSSMATCH

  • The patient's ABO group and Rh type has been done twice and entered in the computer
  • The donor ABO/Rh have been confirmed and entered in the computer. The donor unit identification number, component name, and ABO/Rh type must also be entered in the computer
  • The computer system will alert the technologist to ABO & Rh discrepancies between information on the donor label and results of donor confirmatory testing

The procedure begin in the same manner as the IS cross-match, continues to 37°C incubation and finishes with AHG test.

Method for major cross-match tests

  • In IS (the patient’s serum with donor cell are centrifuge immediately) absence of hemolysis or agglutination indicates compatibility.

  • False reaction may be seen in the presence of other IS reaction (auto -I). In patient with hyperimmune ABO Abs, when the procedure is not performed correctly (delayed in centrifugation or reading) when rouleauex is observed, or when infant’s specimens are tested.

Method for major cross-match tests

  • Cross-match methods can be categorized by the test phase in which the procedure ends.

  • Immediate spin (IS) cross-match (Abbreviated

Cross-match)

  • When no clinically significant Abs are detected nor are there previous record of such Abs, a serologic test to detect ABO incompatibility is sufficient.
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