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Detecting ABO incompatibility with Validated Computer System

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Our facility uses Softbank and we have recently begun using the Ortho Vision.  Vision is not licensed to perform IS crossmatches  using a buffered gel card.  I know that a few years back there was controversy over whether the validated computer system could be substituted for the immediate spin crossmatch and wording for CAP and AABB standards has changed to specify criteria to use the computer system to detect an ABO incompatibility when selecting blood for patients.  My question is:  Has anyone eliminated the IS XM for patients who have a history of (or currently demonstrating) antibodies, perform serological XM incubating at 37, perform reading at AHG phase and allow your validated computer system to detect possible ABO incompatibility?  If yes,  have you been inspected by CAP and/or AABB and was there an issue with it?

I had a great deal of difficulty trying to word this question - since we have just implemented the Vision, it seemed like a good time to look at whether we needed to do the ISXM  for our serologically crossmatched patients.  My medical director agreed but I wanted to see if anyone has gone this route and gone through an inspection before I jump into the frying pan.

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We use manual gel for AHG crossmatches (not IS).  Our procedure states that the computer will detect ABO incompatibility.  The only time we would add an IS XM is  during computer downtime.  We have not been cited for this.

"Under certain circumstances, a transfusion service may elect to omit the antiglobulin phase of the serologic crossmatch. The antiglobulin test may be omitted if the antibody screen is negative and there is no history of detection of unexpected antibodies. Nevertheless, a procedure to demonstrate ABO incompatibility, either a serologic crossmatch or a validated computer system, is required. The computer crossmatch may not be used if the patient has, or has had, evidence of clinically significant alloantibodies. Typing, screening and crossmatching of neonates can be abbreviated if a specific procedure is available.

TRM.40650

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9 hours ago, mollyredone said:

We use manual gel for AHG crossmatches (not IS).  Our procedure states that the computer will detect ABO incompatibility.  The only time we would add an IS XM is  during computer downtime.  We have not been cited for this.

I agree wholeheartedly with this! It's not what's done at my current lab (we do an IS XM with the gel XM), but it was the way I had implemented it at a previous blood bank.  We had no issues with the inspections.

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