Crossmatch procedure for patients with a history of cold or warm autoantibodies

[judith]

Hi Fellow Blood Bankers,

I am looking for documentation for the folllowing cases:

Patient has positive screen in Gel, panel in Gel has some reactions, no specificity, suspect a cold antibody. Prewarm tube antibody screen including auto control is negative. Notation is entered in the computer, non specific cold antibody, use prewarm technique for crossmatching.

Next admission, antibody screen in Gel is negative. My question, is it acceptable to do immediate spin crossmatch since Gel is negative or because of previous history of non specific cold antibody is it required to perform prewarm crossmatch?

The staff is divided on what is the correct procedure to follow and I have not been able to find any documentation other than if antibody is clinically significant, antigen negative units are to have complete crossmatch.

Second question, similiar situation, patient has warm auto antibodies with no underlying allo antibodies.

Next admission, antibody screen is negative in Gel. Same question, for crossmatching, should units be crossmatched in Gel or because antibody screen is negative, is immediate spin acceptable?

Thank you for your time in my double questions.

Judith

[Malcolm Needs ☆]

Unlike alloantibodies that disappear, and can no longer be detected, auto-antibodies can be disregarded once they disappear and can no longer be detected (from the point of view of cross-matching, if not from a clinical perspective). Therefore, I see no reason why an immediate spin cross-match should not be sufficient (and safe) for these patients.

[judith]

Thanks Malcom.

Precisely my thoughts. I enjoy reading your replys, you are so knowledgable.

Judith