Pretransfusion testing without serologic crossmatch: approaches to ensure patient safety.
OBJECTIVE
A crossmatch is usual in pretransfusion testing, but we eliminated it at our tertiary care university hospital. In place of the crossmatch, we have introduced a system where, if an antibody screen is negative, two technologists confirm the ABO of the same patient sample, and we release blood of the patient's type without a serologic or electronic crossmatch.


METHODS
In 65,628 samples received for pretransfusion testing, we studied the effect of common errors that occur from the time of receipt of a sample until release of the blood unit, in order to decide if elimination of the serologic crossmatch would affect patient safety. All sample labels were inspected for acceptability.


RESULTS
A total of 1,082 (1.64%) samples were rejected for mislabeling. Discordance in patient ABO typing results between two technologists was 0.43%. Such discrepancies were resolved before the release of blood units. No donor unit mislabeling or unit release errors were detected.


CONCLUSIONS
Elimination of the crossmatch for red cell antibody-negative patients is safe provided a system of error detection is used. This enhances patient care through the quicker release of blood, increased laboratory efficiency and decreased costs.
Kuriyan
M
M
Transfusion Services, Robert Wood Johnson University Hospital, New Brunswick, NJ 08901, USA. Kuriyame@umdnj.edu
Fox
E
E
D000017:ABO Blood-Group System; D001788:Blood Grouping and Crossmatching / Q000379:methods; D001803:Blood Transfusion / Q000379:methods* / Q000592:standards*; D005334:Fever / Q000209:etiology; D006461:Hemolysis / Q000276:immunology; D006801:Humans; D006967:Hypersensitivity / Q000209:etiology; D015994:Incidence; D007518:Isoantibodies / Q000097:blood; D008403:Mass Screening; D012204:Rh-Hr Blood-Group System; D012449:Safety; D065227:Transfusion Reaction
D000017:ABO Blood-Group System; D007518:Isoantibodies; D012204:Rh-Hr Blood-Group System