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If a transfusion is required and urgent (severe symptomatic anemia), a X-match in IAT at 37°C may be tested. You do not necessarily need P-negative blood (very scarce) unless severe transfusion refractory anemia which would support the need of P negative units. For transfusion, patient should be placed in a warm environment and ensuring that the transfused blood is (pre)warm as well. Hereunder are some references: Clinical and epidemiological features of paroxysmal cold hemoglobinuria: a systematic review - PMC Autoimmune Hemolytic Anemia and Red Blood Cell Autoantibodies | Archives of Pathology & Laboratory Medicine

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Is there any risk of contamination of the screening red blood cells (stroma) with proteolytic enzymes (e.g., papain, ficin) on these systems ? From a diluent used for other assays (some antigen typing tests or antibody screening with enzyme treated cells)?

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