Blood Bank: Compatibility Testing

• Transfusion Order/Requisition (MD/RN)

• Patient ID/Specimen collection (Phleb)

• Specimen ID verification (Phleb)

• Specimen requirements

• Review of pt records (BB)

Pre-Serological Procedures phase of compatibility testing includes which steps (5)

• ABO/Rh typing and ABS

• Ab ID (when positive ABS)

• ABO confirmation

• Rh(D) confirmation on Rh neg units

• Crossmatching of blood for transfution

Serological testing phase in compatibility testing includes which steps? (5)

• Proper release of results (manual/electric)

• Proper labeling of RBC/component

• Proper release of RBC/component

• Proper transportation/storage

• Proper re-release of RBC/component

Post serologic procedure phase in compatibility (5)

C’/hemolysis is present

If Abs are found to be clinically insignificant (IgM), then unit does not necessarily need to be Ag negative to the corresponding Ab, unless…

• Pt phenotyped

• Donor units screened for all corresponding Ags

• AHG crossmatch on Ag neg units

If Abs are found to be clinically significant (IgG), then which steps must be done (3)

• Serum or plasma in pink top (plastic purple K2 EDTA, red)

• Collected within 3 days of Tx (14 if no pregnancy/Tx 3 months)

• No hemolysis

• No dilutions from IV solutions

• Proper pt ID of specimen

• First and last name, MRN, date/time of collection, phleb signature on label

• Tube info = paperwork info

• Stored in fridge for 1 week

Requirements for taking a blood sample from a Tx recipient (8)

• Compare requisition to sample label and ID band

• Verbal confirmation from pt/interpreter/caregiver (not related)

• Label sample at bedside (no prelabel)

Steps to ensure proper pt ID of specimen when taking blood from a Tx recipient (3)

• Anomalies

• Clinically significant Abs

• Tx rxns

• Special Tx requirements

AABB/CAP requires comparison of pt current ABO/Rh blood to historical records, where all previous records must be consulted for (—4—), inconsistensies or problems must be investigated and resolved before proceeding with the transfusion

Rh neg

The transfusing facility Blood Bank is required by AABB standards to confirm all RBC units for their ABO and Rh grouping on units labeled (——)

Near expiration

While good inventory management should conserve Rh negative blood for Rh negative recipients, if the unit is (——) the unit should be given to either Rh pos or neg recipients

no anti-D is demonstrable or history of allo anti-D

Transfusion of Rh neg male patients and/or female patients beyond menooause with Rh pos blood is acceptable as long as (—2—). BB Med Dir and attending physician must be notified. Rh immune globulin therapy may be administered after MD consultation

1. IS crossmatch (final ABO check)

2. Electronic crossmatch

3. Antiglobulin crossmatch (if IgG present)

Crossmatch procedures (3)

• Pt ID error → repeat ABO testing

• Sample label error or WBIT → redraw pt

Causes of ABO typing errors in crossmatch and their resolution (2)

• Cold allo Ab (M, P1) → test panel cells

• Anti A1 in A2 pt →test with lectin and A2 cells

• Cold auto Ab (I, IH) → determine significance; cold auto adsorb

Causes for unexpected Abs in a crossmatch and their resolution (3)

• PLTs

• Thawed plasma

• Cryoprecipitate

(—3—) transfusions require a pt historical or ABO grouping only, no compatibility testing is required

• Pt data: full name, MRN, ABO, Rh

• Unit data: ABO and Rh, product name, donor unit number, exp date, special attributes

• Interpretation of xmat

• CLS ID

• date/time xmat completed

Information on the donor unit transfusion record form (5)

14-55

Childbearing age for women