California - IS XM necessary when LIS can detect ABO incompatability?

[Christine Han ☆]

Good afternoon, 

I am new to the group and this is my first post. Currently I am in California and my blood bank still does IS XM with gel xm when patient requires full AHG crossmatch. We use Ortho Vision. And we do electronic crossmatch on negative absc and no history of antibody. 

This was something new for me because when I worked in New Jersey, we did not perform IS XM along with gel xm since the LIS blood bank system can detect ABO incompatibility. 

I really want to discontinue performing IS XM on patient requiring gel crossmatch since our bb system can detect ABO incompatibility. However, I am new to California, I'm not sure CDPH requires to do IS XM even though the LIS can detect ABO incompatibility. CAP checklist says either serologic or LIS system. However, I want to get everyone's opinion before I present it to the medical director. 

 

Does anyone perform IS XM when patient requires gel xm when the LIS blood bank system detect ABO incompatibility?

 

Thank you for your help. 

Edited April 21 by Christine Han

[Bet'naSBB]

ortho vision IgG cards are not validated to detect ABO incompatibility...............unless you do validation studies and validate it yourself - you must do IS in buffer card or the old fashioned way, in tube.

[applejw]

We do not perform ISXM unless the LIS is down or a second sample for ABO confirmation is not available.  We use Softbank and the system has been validated to detect ABO incompatibility as long as there are 2 blood types tested on record, patient has no history of antibodies and the current antibody screen is negative.

[ktrudell]

We use the electronic crossmatch when the antibody screen is negative and there is no history of antibodies. 

We also use this in lieu of the IS phase when we perform an antiglobulin crossmatch. Our AHG XM's are performed on the Vision with the IgG card.

[Yanxia]

Is can detect anti-Vel which isclinical significant.

[AuntiS]

On 4/22/2024 at 4:01 PM, ktrudell said:

We use the electronic crossmatch when the antibody screen is negative and there is no history of antibodies. 

We also use this in lieu of the IS phase when we perform an antiglobulin crossmatch. Our AHG XM's are performed on the Vision with the IgG card.

Same here in our lab.

[Bet'naSBB]

On 4/20/2024 at 8:32 PM, Christine Han said:

does IS XM with gel xm when patient requires full AHG crossmatch

The question was, do you have to do ISXM when the patient required full XM........  The visions can do the ISXM when they do the full XM - you just have to program it correctly - and it uses a buffer card.

If you don't want to do the IS XM in a buffer card, you would have to do the ISXM in tube to verify ABO Compatibility.  As stated above, The IgG card used for full XM is not "approved" to "catch" ABO compatibility.   I think you have to do it - even if your BB LIS is capable of flagging an ABO incompatibility - but someone correct me if I'm wrong.

[Townsend]

I agree with Bet'naSBB - the IS XM must be done in either tube or gel/other serologic method to verify ABO compatibility.  Since a patient with a current or history of clinically significant antibody does not qualify for electronic crossmatch, the serologic version must be included with the AHG phase XM.