HTLA crossmatchin practice

[tkakin]

I was wondering how other labs manage crossmatches with patients that have HTLA antibodies. 

I understand that if you had pan reactivity in the ID you would not expect there to be much chance of finding crossmatch compatible units and may give least incompatible and have the Dr. sign an increased risk form.

But if you have variable reactivity including negative reactions in the panel and you are able to find crossmatch compatible units (but you have to test many units to find 1) would you try to find them or would you not look and just give Least incompatible and have Dr. sign an increased risk form?

Personally I would test my entire inventory to find one that was compatible but I am not a blood supplier/reference lab.

[Malcolm Needs ☆]

Working in a Reference Laboratory (as I did), we would identify the specificity (for example, anti-McC^a) and then use a bunch of McC(a+) red cells that we have in our collection, to ensure that there are no underlying antibodies of clinical significance.  Once this was done (and assuming no other antibodies were detected), we would inform the hospital that random ABO compatible blood is safe for transfusion.  If the hospital insisted, we would cross-match for them, but would send out suitable, rather than compatible blood.  We had a huge inventory, but we certainly would NOT waste time and reagents looking for McC(a-) units.