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Patty

CAP TRM. 40670

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For laboratories that employ electronic crossmatching, serological crossmatch techniques must be employed when ABO typing discrepancies are present (e.g. mixed filed reactivity, missing serum reactivity, apparent change in blood type post hematopoietic stem cell transplant.)

 

Does a discrepancy still exist if you have figured it out? (As in extra reverse reactions: rouleaux, cold autoagglutinins? Mixed field that you can explain: a B person who received O blood, an A sub group with Anti-A1 ; system set to transfuse type O blood)  How are you satisfying this standard? By procedure only? With Immediate spin crossmatching? Is there any way in Cerner to block electroninic crossmatches for these instances?  Thank you for your input.

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If you have sorted out what is causing the unusual reaction pattern, then it is no longer a discrepancy.  However, I would still not perform an electronic cross-match, AS THERE IS NO SUCH THING (a computer does not, and never has, performed a cross-match).  I would, however, perform ELECTRONIC ISSUE.

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We have set up some criteria not to perform electronic issue if any group discrepancy, any manual group perform to resolve group discrepancy,any mixed field reaction or if antibody screen is positive. And also if patient's demographics not verified , if only one sample available, or sample is not valid. Our LIMS will not allow us to issue electronically in these situations. 

 

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Thank you for the clarification Malcolm.  By the way this came right out of the current CAP standards.  Maybe they need to be schooled too  B)   

COMPUTER CROSSMATCHES

A computer crossmatch is an electronic method that is used to confirm that the unit is appropriate for transfusion

to the intended recipient through the use of validated software logic to determine compatibility, rather than

serologic techniques.

For

laboratories that employ computer crossmatching, serologic crossmatch techniques must be

employed when ABO typing discrepancies are present (e.g. mixed field reactivity, missing serum

reactivity, apparent change in blood type post hematopoietic stem cell transplant).

 

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13 minutes ago, Patty said:

Thank you for the clarification Malcolm.  By the way this came right out of the current CAP standards.  Maybe they need to be schooled too  B)   

COMPUTER CROSSMATCHES

A computer crossmatch is an electronic method that is used to confirm that the unit is appropriate for transfusion

to the intended recipient through the use of validated software logic to determine compatibility, rather than

serologic techniques.

For

laboratories that employ computer crossmatching, serologic crossmatch techniques must be

employed when ABO typing discrepancies are present (e.g. mixed field reactivity, missing serum

reactivity, apparent change in blood type post hematopoietic stem cell transplant).

 

They obviously do!  Patty, PLEASE do not think I was getting at you.  As you will guess from John's post above, this is (just) one of my pet hates.  It was nothing personal!

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When we called CAP, we were told we could perform electronic crossmatches as long as our policy defined an ABO discrepancy as one that is unresolved. If we know why there is a discrepancy, we can do the EXM.

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They also said they would update the wording in this standard in August, but for now to update our policy so we're in compliance.

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