Red Cell Crossmatch Techniques
Continuing Education Credits
This course covers the various requirements for crossmatching units of packed red cells: patient history, current antibody screen results, and more. Various blood group system antibodies and whether those antibodies are clinically significant is assessed. Different methodologies for carrying out the crossmatch and their associated requirements are also discussed.
Objectives
- Describe the various red cell crossmatch methods and their uses.
- Define the common regulations and guidelines for crossmatching of red cells.
- Define requirements for the computer crossmatch.
- Identify the regulations for crosssmatching of red cells.
- Identify accrediting agency requirements for crossmatching of red cells.
- Select the appropriate crossmatch for the scenario described.
Course Outline
- Describe the Various Red Cell Crossmatch Methods and Their Uses
- Red Cell Crossmatch Techniques
- Course Objectives
- Describing Various Crossmatch Techniques
- What is a Crossmatch?
- Goals of Method Selection
- Significant and Insignificant Antibodies
- Considerations in Method Selection
- Variables in Methods
- How Many Readings
- Antiglobulin Reagents
- Standard Crossmatch Methods
- Crossmatch Methods
- Crossmatch Methods, continued
- Antigen Matching
- Special Crossmatch Methods
- Special (Rare) Situations
- Regulatory Requirements for Crossmatching
- General Requirements
- Match the word to the definition.
- Match the clinical significance to the antibody.
- Which of the following crossmatch methods would be the best method of detecting ABO incompatibility?
- Define the Common Regulations and Guidelines for Crossmatching of Red Cells
- Crossmatch Requirements
- Crossmatch Requirements, continued
- Crossmatch Requirements, continued
- Which organization does not have a specific requirement for using antigen-negative blood components if the patient has a clinically significant antibody?
- Define Requirements for the Computer Crossmatch
- Computer Crossmatch Requirements
- Computer Crossmatch Requirements, continued
- Computer Crossmatch Requirements, continued
- True or False: The software vendor can validate the computer crossmatch using the software at the vendor site.
- True or False: The FDA does not have regulations concerning the computer crossmatch.
- True or False: The computer (electronic) crossmatch can be the only crossmatch method used when the patient has clinically significant antibodies.
- Identify the Regulations for Crossmatching Red Cells
- Identify the Regulations for Crossmatching Red Cells
- Compatibility Testing CFR
- Compatibility Testing CFR, continued
- Compatibility Testing CFR: CLIA
- Compatibility Testing CFR: FDA
- Compatibility Testing CFR: Sample Retention
- CFR: Record Retention
- CFR: Record Retention, continued
- CFR: Record Retention, continued
- FDA Guidance on the Electronic Crossmatch
- More FDA Guidance on the Electronic Crossmatch
- Donor Unit Requirements
- Validation
- Validation, continued
- Decision Rules: Validation
- Decision Rules: Warnings
- True or False: A specimen collected four days previously can be used to crossmatch units for a patient who is currently pregnant.
- True or False: When pretransfusion testing specimens are collected, positive patient identification is required.
- Identify Accrediting Agency Requirements for Crossmatching Red Cells
- AABB Requirements
- AABB Requirements: Pretransfusion Testing
- AABB Requirements: ABO
- AABB Requirements: Rh
- AABB Requirements, continued
- Serologic Crossmatch
- Serologic Crossmatch: ABO Incompatibility
- Unexpected Antibodies
- Unexpected Antibodies, continued
- Computer Use for Detecting ABO Incompatibility
- Computer Use for Detecting ABO Incompatibility, continued
- CAP Requirements for Crossmatching
- CAP Requirements for Crossmatching: Laboratory Information System Validation
- CAP Requirements: Age of Specimen
- CAP Requirements for Crossmatching, continued
- CAP Requirements for Crossmatching, continued
- CAP Requirements for Crossmatching: Autologous Units
- CAP Requirements for Crossmatching: Computer Crossmatch
- CAP Requirements for Crossmatching: ABO and Rh
- CAP Requirements: Data Entry Verification
- CAP Requirements: Donor Unit and Recipient Information
- Joint Commission (TJC) Requirements
- TJC Requirements, continued
- TJC Requirements, continued
- TJC Requirements, continued
- TJC Requirements, continued
- TJC Requirements: Patient Identification and Specimen Labeling
- TJC Requirements: Specimen Collection and Labeling
- TJC Requirements: ABO and Rh Typing
- TJC Requirements, continued
- TJC Requirements: Rh Negative
- TJC Requirements: Written Procedures/Policies
- TJC Requirements, continued
- TJC Requirements, continued
- TJC Requirements, continued
- TJC Requirements, continued
- TJC Requirements, continued
- Commission on Office Laboratory Accreditation (COLA) Requirements
- COLA Requirements, continued
- COLA Requirements, continued
- COLA Requirements, continued
- COLA Requirements, continued
- COLA Requirements, continued
- COLA Requirements, continued
- True or False: If the gel crossmatch is used, a second crossmatch must be performed to detect clinically significant antibodies.
- True or False: All accrediting agencies listed in this course require there be a 37°C reading before the antiglobulin phase of the antiglobulin crossmatch.
- Which of the following reagents is required to confirm the blood type of a donor unit that is labeled Group A Rh negative?
- Which of the following is required by the College of American Pathologists for validation of the computer crossmatch?
- Select an Appropriate Crossmatch for the Scenarios Described
- Crossmatching Scenarios
- Scenario #1
- Scenario #1, continued
- Scenario #2
- Scenario #2, continued
- Scenario #3
- Scenario #3, continued
- Scenario #4
- Scenario #4, continued
- The warm crossmatch should be considered when the patient has a current positive antibody screen and which of the following?
- Group O red cells must be administered unless there is a previous result or a second specimen for which pretransfusion test?
- References
- References
Additional Information
Level of Instruction: Intermediate
Intended Audience: Medical laboratory scientists, medical laboratory technicians, laboratory supervisors, and laboratory managers. This course is also appropriate for MLS and MLT students and pathology residents.
Author Information: Suzanne H. Butch, MA, MLS(ASCP)CMSBBCM, DLM, is the Administrative Manager for Healthcare, Blood Bank & Transfusion Service at the University of Michigan Hospitals and Health Centers in Ann Arbor, Michigan. She holds a Bachelor's degree in Medical Technology from the University of Michigan, a Master's degree in Management and Supervision from Central Michigan University, and Certifications as a Specialist in Blood Bank, as a Quality Audit, and as a Diplomate in Laboratory Medicine. She has edited books and written numerous book chapters and articles. She has been invited to present numerous lectures on computerization in blood banks, automation, and transfusion medicine.
Reviewer Information:
Sheri Goertzen, MLS(ASCP)BB, CLS(CA), CQA(ASQ), has over 25 years of experience as the Supervisor of Transfusion Services at Valley Children's Healthcare in Madera, CA, and almost 40 years of experience in transfusion services. She has presented at AABB conferences and served as a contributing member or committee chair on several AABB committees.
Laurie Bjerklie, MA, MLS(ASCP)CM, is
an Education Developer for MediaLab and LabCE. She earned a B.S. in Medical
Laboratory Science from the University of North Dakota and an M.A. in
Curriculum and Instruction from Saint Xavier University. She has over 15 years
of experience in higher education and has held program director and faculty
positions in both MLT and MLS programs.