I think what LCoronado is trying to say is that with a gel crossmatch, having a computer system which detects ABO incompatibilites would be equivalent to an IS crossmatch. I don't think she was talking about an electronic crossmatch for patients with antibodies. Our computer system will not let us crossmatch an A unit to an O patient, just like an IS crossmatch.

We do not perform computer crossmatch here and I am very interested about computer crossmatches. I've asked a friend of mine who is SBB, he said the way the guidance is written if clinically significant antibodies are not detected then you can rely on computer crossmatch but if there is ABO typing problem you can not. As for performing IS in addition to gel, he said blood bankers have different opinions but those who get inspected by AABB and FDA will definitely perform IS to be compliant.

We do not perform computer crossmatch here and I am very interested about computer crossmatches. I've asked a friend of mine who is SBB, he said the way the guidance is written if clinically significant antibodies are not detected then you can rely on computer crossmatch but if there is ABO typing problem you can not. As for performing IS in addition to gel, he said blood bankers have different opinions but those who get inspected by AABB and FDA will definitely perform IS to be compliant.

Your SBB friend is correct. However, the FDA document referenced is for guidance, it is not regulatory.

Your SBB friend is correct. However, the FDA document referenced is for guidance, it is not regulatory.

True...You can have the take it or leave approach when it comes to any Guidance, but, they are based on current regulations. A facility make take AABB's instead which in a lot of cases is more stringent than FDA's. Per FDA "You can use an alternative approach if the approach satisfies the requirements of the applicable statutes and regulations."

I have never seen a clinically significant anti A1. I know they are out there but I don't worry about them. I am more worried about a Kpa or Jsa that I could be missing with my screening cells. You can only do so much.

R1R2

Be thankful that you don't encounter Kpa or Jsa on your screens cells and add them to your list of things you don't worry about. :cool:

I remember having a screening cell once with Jsa on it....We identified a couple that month.

I think what LCoronado is trying to say is that with a gel crossmatch, having a computer system which detects ABO incompatibilites would be equivalent to an IS crossmatch. I don't think she was talking about an electronic crossmatch for patients with antibodies. Our computer system will not let us crossmatch an A unit to an O patient, just like an IS crossmatch.

Yes thank you - that is what I was trying to say.

I like to know whether a negative crossmatch by gel technology alone taken as sufficient crossmatch for transfusing red cells. Assuming that atypical antibody screening done again by gel technique. Recently I came across a sample which did not show any atypical antibodies by gel but did show saline reactive Anti A1 antibody reactive at 37 .C . Gel did not pick up this. Is it necessary to do saline crossmatch in addition to gel cross match ?

SPS

AABB stds requires you to perform a crossmatch for ABO incompatibility. This is done by immediate spin [in a tube] or by electronic crossmatching

Be thankful that you don't encounter Kpa or Jsa on your screens cells and add them to your list of things you don't worry about. :cool:

you have probably missed many of these . . . I have found them to more prevalent than I would have believed,esp Kpa. . . . don't see any transfusion reactions due to them though . . .