Compatibility Testing for Red Blood Cell Components: Approaches and Limitations
Compatibility testing for red blood cell transfusion in U.S. health care facilities consists of a specified series of steps, defined in the American Association of Blood Banks’ (AABB’s) Standards for Blood Banks and Transfusion Services (Standards) (1) and further described in the AABB’s Technical Manual (2). The elements of this process include assuring that a physician order exists and that a proper request has occurred, obtaining or receiving a properly collected and labeled patient sample, testing the patient sample for ABO and Rh, performing a historical check of prior patient ABO, testing of donor unit for ABO (and D, if D-negative), screening patient serum for unexpected antibodies, identifying any unexpected antibodies, and performing a crossmatch between donor cells and patient serum (or an electronic cross-match if specific conditions are met). At every step in this process, choices occur (Fig. 1). To ensure that all appropriate actions occur, a checklist is helpful. Table 1 is an example of a checklist based in part on the AABB’s Quality Program, System I: Compatibility Testing (3).
KeywordsDonor Cell Massive Transfusion Compatibility Test Direct Antiglobulin Test Donor Unit
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