Initial Spin Crossmatching

[jhaig]

We currently do all of our crossmatching of RBC units in gel. The crossmatches are set up along with the patient's antibody screen. This works in cases where there is no immediate need for transfusion. But we have had an increasing number of complicated O.R. cases and other emergent transfusion needs which required blood sooner than later. These cases did not fall under our emergency transfusion protocol (amazing that when you suggest to a physician that they can have the blood right away if they sign an emergency release, the need for it seems to become less emergent).

What I want to do is do immediate spin crossmatches for cases that require blood right away, but are not emergencies. If this change is made, should I switch everything to initial spin as long as the patient has a negative antibody screen? Or should initial spins be limited to critical cases?

[Cathy]

We do immediate spin crossmatches on everyone unless there is a problem, in which case we do antiglobulin crossmatches.

[MM@WIH]

We also do immediate spin only crossmatches on all patients unless they have a history of a positive antibody screen/identified antibody.

[Lcsmrz]

It is probably easier and less complicated to develop one crossamatching technique for all patients, whether they are urgent or not. Immediate-Spin crossmatching has been around since the 90's and has a strong safety record, as will electronic crossmatching in the future.

We do IS XM, unless there is a current or historical antibody that is clinically significant.

[Mabel Adams]

IS xms allows you to "get the screen cooking"; then you can do the type and xms during the incubation (barring antibodies of course).