Pathology consultation on electronic crossmatch.
OBJECTIVE
The full crossmatch is traditionally the final step in compatibility testing, acting as a serologic double check for ABO compatibility and unexpected RBC antibodies. In this review, we discuss the development of electronic crossmatch (EXM), an approach for determining when EXM can be used, and its strengths and weaknesses.


METHODS
Because EXM relies on highly sensitive screening assays, antibodies are frequently encountered whose clinical significance must be investigated and interpreted. Our approach is to obtain further history, perform enhanced tube testing, and consider tests of immune reactivity or RBC survival.


RESULTS
For those without clinically significant antibodies, we found two alternatives: immediate-spin crossmatch (IS XM) and EXM. IS XM is prone to error related to serologic interference, whereas EXM depends on the accuracy of the sample label, accurate data entry, and informatics to avoid errors.


CONCLUSIONS
EXM is an alternative to the serologic test in patients who have no clinically significant antibodies.
101 Manning Dr, Memorial Hospital, 1021 East Wing, Campus Box 7525, Chapel Hill, NC 27599; mmazepa@unch.unc.edu.
Marshall A
MA
Mazepa
Jay S
JS
Raval
Yara A
YA
Park
D000017:ABO Blood-Group System / Q000276:immunology*; D001787:Blood Group Incompatibility / Q000276:immunology* / Q000473:pathology; D001788:Blood Grouping and Crossmatching; D001803:Blood Transfusion; D005260:Female; D006801:Humans; D007518:Isoantibodies / Q000097:blood / Q000276:immunology*; D008875:Middle Aged; D012017:Referral and Consultation
D000017:ABO Blood-Group System; D007518:Isoantibodies
Crossmatch; EXM; Electronic crossmatch