First Indian study to establish safety of immediate-spin crossmatch for red blood cell transfusion in antibody screen-negative recipients.
OBJECTIVE
The US Food and Drug Administration and American Association of Blood Banks approved the type and screen approach in 1980s, long after antibody screen (AS) was introduced in 1950s. The present study omits conventional anti-human globulin (AHG) crossmatch and replaces it with immediate-spin (IS) crossmatch as part of pretransfusion testing in AS-negative patients to study the safety and effectiveness of IS crossmatch in recipients.


METHODS
This prospective longitudinal study was conducted on over 5000 red cell units transfused to AS-negative patients admitted to the hospital. Pretransfusion testing comprised blood grouping and AS followed by IS crossmatch, at the time of issue of red cell unit. The patients were transfused IS compatible red cell units. AHG crossmatch was performed posttransfusion for all red cell units. Any incompatible AHG crossmatch was followed up as suspected transfusion reaction.


RESULTS
A total of 5023 red cell units were transfused to 2402 patients with negative AS. 99.7% IS compatible red cell units were also compatible on posttransfusion AHG crossmatch. Anti-P1 alloantibody was identified in one patient who was transfused two IS crossmatch compatible units but later both units were incompatible on AHG crossmatch. There was no clinical or serological sign of hemolysis in the patient.


CONCLUSIONS
In AS-negative patients, IS crossmatch is as safe as conventional AHG crossmatch and can, therefore, replace conventional AHG crossmatch protocol.
Department of Transfusion Medicine, Medanta - The Medicity, Gurgaon, Haryana, India.
Aseem Kumar
AK
Tiwari
Department of Transfusion Medicine, Medanta - The Medicity, Gurgaon, Haryana, India.
Geet
G
Aggarwal
Department of Transfusion Medicine, Medanta - The Medicity, Gurgaon, Haryana, India.
Ravi C
RC
Dara
Department of Transfusion Medicine, Medanta - The Medicity, Gurgaon, Haryana, India.
Dinesh
D
Arora
Department of Transfusion Medicine, Medanta - The Medicity, Gurgaon, Haryana, India.
Gautam Kumar
GK
Gupta
Department of Laboratory and Transfusion Services, Medanta - The Medicity, Gurgaon, Haryana, India.
Vimarsh
V
Raina
Anti-human globulin; immediate-spin crossmatch; pretransfusion testing; red blood cell transfusion; type and screen