crossmatches with warm autos

[Mabel Adams]

Since units aren't really compatible in vivo in the presence of a warm auto, how do you all handle crossmatches?

Assuming you found no underlying allos and no cold antibodies, do you: crossmatch the units by AHG with the absorbed sample but still turn it out as incompatible, IS crossmatch the units with unabsorbed sample to confirm the ABO type but still turn it out as incompatible, AHG crossmatch with unabsorbed sample and turn them out as incompatible, not crossmatch at all but call them incompatible, do some combination of the above or something else. My computer will insist I call them Least Incompatible because it won't keep the unit associated with the patient if it is entered as "incompatible." Or I could call them "compatible" and add some caveat to the results.

[bevydawn]

We don't do adsorptions at my facility so we send our WAA's to our reference lab. They call them incompatible, but compatible using adsorbed serum. We then crossmatch them in gel and call them least incompatible (we have the same issue with calling them incompatible) and footnote that they were compatible using adsorbed serum per our reference lab.

[janet]

First time we would send out to our reference lab for autoabsorbtion and phenotype. They would cross with autabsorbed plasma if allo-antibody present or computer crossmatch if no antibodies in the autoabsorbed plasma. Both have a comment added "normal survival cannot be expected". After that initial testing we would give phenotypically matched "least incompatible". Our computer system lets us give out these "least incompatibe".