TRM.40651 Autologous unit crossmatch

[Bill Sinn]

This is a new item, and we will have to change our SOP's. We have not been doing an actual crossmatch of auto units. It has not been previously required by AABB or CAP, to my knowledge.

We were doing type and screen of patient, confirming all ID on patient sample and auto labeling agreed, and doing the ABO ang Rh of the unit.. making sure they agree, of course.

I wonder what the CAP's concern is?

[nmartin]

Prior to this checklist item, we only did a blood type on the patient specimen and reconfirmed the auto unit, then with no further testing other than clerical, allocated the auto unit to the patient.

Because of this new checklist item, we also changed our SOP to include a crossmatch and antibody screen.

The consensus here in San Diego, among the majority of hospitals queried is to treat an autologous unit like an allogeneic unit, with both the Antibody screen and crossmatch performed.

[Liz0316]

We do an antibody screen on the first unit, and of course the required ABO/Rh on all donated units. The crossmatch (for the auto units) is immediate spin regardless of antibody screening status. Of course any additional units would require regular requirements.

[CPSHAN56]

We are currently preforming an ABO/Rh, AB screen on patient sample and of course confirming the ABO/RH on the autologous unit. No crossmatch. We just discussed dropping the AB screen on the patient because they rarely take a unit other then the autologous unit. Are most people preforming an AB screen on these patients?

[Eagle Eye]

we were doing type and screen on this pateints but now we included crossmatch. If patient has antibody we will retype the units. For 2 reasons 1) our computer system will not let us issue unit unlesss we override the flag. 2) by doing antigen typing you want to make sure that you have correct unit(no labeling error at the blood center).

[Mary]

We do not do an antibody screen unless additional homologous units are ordered. We keep the specimens that have not had an antibody screen in a separate rack, so if subsequent orders are received, we know to perform an antibody screen.

[schneidk4]

We have always done an immediate spin crossmatch on our autos, as well as an antibody screen. If the patient has an antibody and more blood is needed stat, it certainly is easier if you know what you're dealing with.

[Karen Olsen]

We have always performed an antibody screen and crossmatches. We did however skip the Antigen typing of the unit if the patient had a known Ab detected in the auto unit. We would just crossmatch through coombs.

[Kwenz]

We have always treated an auto unit and the associated patient sample the same as any other patient and unit. There is always the possibility of a labeling error.

[AMcCord]

We do the same as KWenz.

[Liz0316]

the concern is that the patient goes home and comes back. Hopefully it's the same patient!

[LAS]

So do we.