Increased efficiency of transfusion practice in routine surgery using pre-operative antibody screening and selective ordering with an abbreviated crossmatch.

In an effort to meet the increasing demands for blood to cover routine surgery and in order to reduce the amount of time-expired blood, we have adopted a system of grouping and screening patients' blood preoperatively but not crossmatching blood unless there is more than a 30 per cent chance that it will be used. This approach is based on schemes developed in the USA over the past three decades. If there is unexpected haemorrhage at operation and the patient's serum is known to be free of irregular antibodies, blood of the same ABO group is provided, with only an abbreviated crossmatch to check ABO compatibility. During the first 6 months in which the new scheme was in operation it is estimated that the laboratory crossmatched at least 3000 units of blood (44 per cent) less than it would otherwise have done. 336 units were transfused after an abbreviated crossmatch and, as expected, there were no haemolytic transfusion reactions.