Hi, if the clinician request additional unit of red cells from type & screen sample within 72 hour period (patient already transfused), do you:

1. Crossmatch using existing T&S sample

2. Request new sample, repeat T&S, then crossmatch using new sample

 

to make it clear, i give you all case scenario:

1.1.2016: T&S sample send

2.1.2016: request 1 unit of red cells then transfused

3.1.2016: request another unit of red cells. So in this junction, do you just crossmatch using existing sample or request new sample then do all over again.

My concern is for patient who already has antibody, but undiagnosed before and undetected during current admission (antibody strength deteriorated over time), once expose to corresponding antigen, may rapidly produce antibody via secondary immune response. How rapid? I dont know

tq in advance

Perform Crossmatch using existing T&S sample.   The sample is valid and there is not enough time to develop an antibody .

 

Although Kandahlawi's last point may seem valid, I agree that re-performing the screen on a new specimen is not necessary in this case.  

Scott

Use the original type and screen .

 

same sample.  good for 3 days regardless of intervening transfusions

Same sample.

Same sample.

I agree that you would use the first sample for subsequent transfusions until the sample expires.  Your point that the person may have an unexpected antibody prior to the first transfusion that then explodes with a second unit could happen. If the patient does have a transfusion reaction because an unexpected antibody was present that could not be detected with the first antibody screen, it could result in a delayed reaction (>24 hours but less than 28 days after transfusion).  It generally wouldn't be an immediate hemolytic...unless the wrong blood type is transfused.      If the patient did have an unexpected, undetectable antibody and had a reaction; your transfusion reaction work up would discover this and moving forward, your transfusion service would have information to give antigen negative blood.  As blood bankers we want to give the best product all the time.  Following the rules/processes/procedures will help us stay on that course. 

AABB Standards indicate the blood bank specimen is good until midnight on day 3 after collection with day 0 being the day of collection.  Your specimen is good for crossmatching units until midnight on the expiration date, and the crossmatched units are also good for the same time period.

Guess I'll make it unanimous, use the sample, that's what it's there for.  You can drive yourself crazy with "what ifs" and blood bankers are the best at it I have ever seen, myself included.