Cross-matching

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Cross-matching
Intervention
MeSH D001788
Cross-matching blood, in transfusion medicine, refers to the complex testing that is performed
prior to a blood transfusion, to determine if the donor's blood is compatible with the blood of an
intended recipient, or to identify matches for organ transplants. Cross-matching is usually
performed only after other, less complex tests have not excluded compatibility. Blood
compatibility has many aspects, and is determined not only by the blood types (O, A, B, AB), but
also by blood factors, (Rh, Kell, etc.).
Cross-matching is done by a certified laboratory technologist, in a laboratory. It can be done
electronically, with a computer database, or serologically. Simpler tests may be used to
determine blood type (only), or to screen for antibodies (only). (indirect Coombs test).
Contents
1 Types of cross-matching
o 1.1 Electronic cross-matching
o 1.2 Serological cross-matching
2 Emergencies
3 External links
[edit] Types of cross-matching
[edit] Electronic cross-matching
Electronic cross-matching is essentially a computer-assisted analysis of the data entered from
testing done on the donor unit and blood samples drawn from intended recipient. This includes
ABO/Rh typing of the unit and of the recipient, and an antibody screen of the recipient.
Electronic cross-matching can only be used if a patient has a negative antibody screen, which
means that they do not have any active red blood cell atypical antibodies, or they are below the
detectable level of current testing methods. If all of the data entered is compatible, the computer
will print a compatibility label stating that the unit is safe to transfuse.
[edit] Serological cross-matching
In serological cross-matching, red blood cells from the donor unit are tested against the serum of
the patient in need of the blood transfusion. If the patients serum contains antibodies against the
antigens present on the donor red blood cells, agglutination will occur. Agglutination is
considered a positive reaction indicating that the donor unit is incompatible for that specific
patient. If no agglutination occurs the unit is deemed compatible and is safe to transfuse.
Cross-matching falls into two categories:
Major Cross-match: Recipient serum is tested against donor packed cells to determine if the
recipient has preformed antibodies against any antigens on the donor's cells. This is the
required cross-match prior to release of a unit of packed cells.
Minor Cross-match: Recipient red cells are tested against donor serum to detect donor
antibodies directed against a patient's antigens. This is no longer required. It is assumed that
the small amount of donor serum and antibodies left in a unit of packed cells will be diluted
in a recipient.
[edit] Emergencies
In the case of an emergency a physician, physician assistant, or nurse practitioner can request
"uncross-matched blood", or donor units of blood that have not been cross-matched. It is thought
that this lifesaving measure is of more benefit than any risk of an antibody-mediated transfusion
reaction. In addition, the risk of a serious transfusion reaction can be minimized if the donor unit
is both ABO-compatible and Rhesus (Rh)-compatible. Type O and Rh negative blood can be
given if the recipient's blood group is not known, as may happen in an emergency. In an
emergency, blood grouping can be done easily and quickly in 2 or 3 minutes in the laboratory on
glass slides with appropriate reagents, by trained technical staff. This method depends on the
presence or absence of agglutination, which can usually be visualized directly, although
occasionally a light microscope may be needed. If laboratory services are not available, another
system of deciding which type of blood to use in an emergency is the bedside card method of
blood grouping, where a drop of the intended recipients' blood is added to dried reagents on a
prepared card. This method may not be as reliable as laboratory methods, which are preferable.
[edit] External links
HealthAtoZ.com Blood typing and crossmatching
Nobelprize.org Interactive online game for blood typing and transfusion (Flash Player 5
required)
v d eTransfusion medicine

General concepts
Apheresis (plasmapheresis, plateletpheresis, leukapheresis) Blood
transfusion Coombs test (direct and indirect) Cross-matching
Exchange transfusion International Society of Blood Transfusion
Intraoperative blood salvage ISBT 128 Transfusion reactions

Blood group systems/
blood types
ABO Chido-Rodgers Colton Cromer Diego Dombrock
Duffy Gerbich GIL Hh Ii Indian JMH Kell (Xk) Kidd
Knops LW Lewis Lutheran MNS OK P Raph Rh and
RHAG Scianna T-Tn Xg Yt Other

Blood products/
blood donation
Whole blood Platelets Red blood cells Plasma/Fresh frozen
plasma/PF24 (Cryoprecipitate + Cryosupernatant)
Blood substitutes

M: MYL cell/phys (coag, heme,
immu, gran), csfs
rbmg/mogr/tumr/hist,
sysi/epon, btst
drug (B1/2/3+5+6),
btst, trns

Retrieved from "http://en.wikipedia.org/wiki/Cross-matching"
Categories: Transfusion medicine | Hematology
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