What do other do require for transfusing patient's with a strong WAA or strong CAA? What type of crossmatch is used and what antigen are being honored for these patients? We currently use 'in vivo' or biological crossmatches but am curious to see what others do.
This is what we do for WAA:
T&S-Initial testing will be on ECHO; If patient has a known WAA, testing is performed with LISS to avoid WAA interference.
Perform panel and DAT. Expected results panagglutination and DAT positive.
Perform elution studies. Expected result, panagglutination with eluate.
Complete phenotype or partial phenotype (Rh, Kell, Kidd) if patient has not been transfused. Perform PeG auto or allo-adsorptions with W.A.R.M. treated cells as necessary.
If patient has been transfused, perform triple allo-adsorption with donor cells.
Send patient sample for molecular phenotyping for future transfusions.
Crossmatch with neat plasma. If incompatible, perform ‘in vivo’ crossmatch with Rh, Kell, Kidd matched units with emergency release.
CAA with incompatible blood are also 'in vivo' crossmatched with Rh, Kell, Kidd matched units with emergency release