Red Cell blood components require compatibility testing prior to a transfusion to ensure that the product is compatible to the patient/recipient.
Note: A transfusion order (“Transfuse RBC”) must be placed/activated in order to release the crossmatch blood from the Blood Bank.
Useful For
Pretransfusion testing must be completed for patients requiring a red cell transfusion to ensure that the red cells transfused are compatible. Pretransfusion testing includes, Type and Screen, antibody identification when applicable, and a crossmatch. A crossmatch is performed to ensure that the red cells selected for transfusion are compatible for the patient. A computer/electronic crossmatch will be performed on a patient with whose blood type (ABO Rh) is verified, blood type and antibody screen is current (within 72 hours), and no present or previously identified clinically significant antibodies. Patient’s with a positive antibody screen or a history of clinically significant antibodies must be crossmatched using the antiglobulin technique, to detect serological incompatibility. The testing of the patient’s serum with donor’s red cells with the antiglobulin technique is required because it is the most efficient way to detect antibodies that might damage transfused red cells and cause a hemolytic transfusion reaction.
Method Name
Computer/Electronic Crossmatch: Performed on patients with a current and verified ABO Rh type, negative antibody screen, and no history of a clinically significant antibody.
Serological Crossmatch: Patient’s with a positive antibody screen or a history of clinically significant antibodies must be crossmatched using the antiglobulin technique, to detect serological incompatibility. Hemagglutination (Tube and Gel Methods). Primary method is Gel.
Important Note
If the patient has an antibody history and a red cell transfusion is anticipated, please have the patient drawn ahead of time to complete the pretransfusion testing. Contact the Blood Bank in advance when possible to coordinate.
Aliases
Cross, Crossmatch, Type And Cross, Type And Cross, Transfuse Rbcs, Transfuse, Transfuse Rbc, Rbc, Crossmatch Rbc, Crossmatch Rbcs
Specimen Type
Patient Sample: Plasma
Donor Sample: Red Cells Unit
Specimen Required
Large lavender-top (EDTA) tube, approximately 7 mL
After the patient is positively identified, the sample is drawn and fully labeled with the following information either electronically or handwritten:
- Patient’s full First and Last Name
- Date of Birth or Medical Record Number (MRN#)
- Date and Time specimen was drawn
- Blood Bank Armband Number (BBID) (see below for more information)
- Identity of the person who collected the specimen (Ex: Cerner ID or personnel initials)
All inpatients, or patients potentially receiving a transfusion, must have a blood bank armband (BBID) applied to their wrist and the Blood Bank ID (BBID) number written on the tube. This blood bank armband is a secondary patient identifier that helps ensure a safe and accurate transfusion. Specimens received without a blood bank armband will be rejected. See special instructions for more information.
NOTE: If the patient has a complicated antibody identification work up, additional samples may be required.
If the patient has a history of a complicated antibody identification, please drawn two (2) Large lavender top (EDTA) tubes, approximately 7 mL in case the sample needs to be sent to the reference lab for further testing.
Specimen Minimum Volume
1.0 – 4.0 mL
NOTE: If the antibody identification is a complicated work up or the patient has a history of a complicated antibody workup, additional samples may be required. If the patient has a history of a complicated antibody identification, please draw two (2) Large lavender top (EDTA) tubes in case the sample needs to be sent to the reference lab for further testing.
Specimen Stability Information
Stable at room temperature for 24 hours.
Rejected Due To
- If the patient’s full first and last name and date of birth are not clear, accurate, and/or readable the specimen must be rejected.
- If the Blood Bank Armband Number (BBID) from the Blood Bank Armband is missing, inaccurate, illegible and/or can not be confirmed on all inpatient and outpatient potential transfusion specimens, the specimen must be rejected and sample redrawn.
- Specimens may be rejected for insufficient quantity and/or quality reasons (Ex: Hemolysis, Clotted, dilution, etc).
- If there is any doubt as to the identity of the sample, a new sample must be obtained.
- If a specimen is rejected on a trauma, OR, or other critical patient when blood is needed urgently/immediately, have the specimen redrawn in accordance with this policy and follow the policy “Issue of Blood in Urgent Situations”. Uncrossmatched blood can still be given in an emergent situation.
- In the case of a positive antibody screen or history of an antibody, the Provider must evaluate the necessity of blood urgently as the uncrossmatched blood released may be incompatible and may cause a hemolytic transfusion reaction.
Special Instructions
- The person drawing the blood sample must confirm the patient’s identity by checking at least two independent identifiers before collected a specimen such as: first name, last name, date of birth, and medical record number. If possible, patient identification should be obtained verbally directly from the patient. The phlebotomist must not rely on a bed tag or on charts or records placed nearby. After positively identifying the patient, the sample is drawn and fully labeled with the following information either electronically or handwritten: Patient’s full first and last name, date of birth or medical record number (MRN#), date and time specimen was drawn, Blood Bank Armband Number (see below for more information), and identity of the person who collected the specimen (Ex: Cerner ID or personnel initials).
- All inpatients, or patients potentially receiving a transfusion, must have a Blood Bank Armband applied to their wrist and the Blood Bank Armband Number (BBID) number written on the tube. Please write the number clearly and do not use a gel pen (anything written in gel pen smears as the specimen is transported in a bag to the lab). This blood bank armband is a secondary patient identifier that helps ensure a safe and accurate transfusion. Specimens received without a blood bank armband ID will be rejected.
Performing Laboratory
Glens Falls Hospital Laboratory
If sample needs to be sent out for further testing the sample will be processed at a reference lab.
- Primary reference lab is the American Red Cross West Henrietta, NY
Reference Values
Compatible
CXM-Compatible (Computer/Electronic Crossmatch Compatible)
Incompatible
- NOTE: There are situations in which a patient has developed an antibody that will require crossmatch incompatible blood to be transfused (HTLA, HLA hemagglutinins, IgG autoantibodies, etc.). If a patient is being given incompatible blood, it is essential that the attending physician be notified of this prior to transfusion. Please call the Blood Bank or Pathologist for guidance.
Day(s) and Time(s) Performed
24 hours 7 days a week
Analytical Time
STAT with Type and Screen completed no clinically significant antibodies turn around time approximately 2 minutes.
STAT with Type and Screen not completed/pending turn around time approximately 1 hour.
Routine with Type and Screen completed no clinically significant antibodies turn around time approximately 30 minutes.
Routine with Type and Screen not completed/pending turn around time approximately 2- 4 hours.
Patients with a clinically significant antibody or history of a clinically significant antibody will require a longer turn around time that is dependent on the antibody identified and blood availability with the corresponding negative antigen. In complicated cases where compatible blood is rare and limited, the blood products may need to be sent from the reference lab. The main reference lab is located in West Henrietta, NY.
Specimen Retention Time
10 Days
Analytical Time
STAT with Type and Screen completed no clinically significant antibodies turn around time approximately 2 minutes.
STAT with Type and Screen not completed/pending turn around time approximately 1 hour.
Routine with Type and Screen completed no clinically significant antibodies turn around time approximately 30 minutes.
Routine with Type and Screen not completed/pending turn around time approximately 2- 4 hours.
Patients with a clinically significant antibody or history of a clinically significant antibody will require a longer turn around time that is dependent on the antibody identified and blood availability with the corresponding negative antigen. In complicated cases where compatible blood is rare and limited, the blood products may need to be sent from the reference lab. The main reference lab is located in West Henrietta, NY.