Implementing type and screen method replacing conventional antiglobulin crossmatch procedure for compatibility testing in elective protocol in a tertiary care hospital.

INTRODUCTION

Pretransfusion testing is an essential and important investigation to provide safe and fully compatible packed red blood cell (PRBC) unit to the recipient to prevent the fatal hemolytic transfusion reaction. Type and screen (T and S) procedure is one of the effective approaches in pretransfusion testing in which antibody screen (AS) negative recipients are transfused with an immediate saline phase compatible PRBC unit. In order to explore the feasibility of implementing T and S protocol in our institute, this study was carried out. The main aim of our study was to compare the T and S protocol in AS-negative recipients with anti-human globulin (AHG) phase crossmatch in patients requiring PRBC under elective protocol.

MATERIALS AND METHODS

Our study was a cross-sectional analytical study carried out in all the elective blood samples with a history of transfusion or pregnancy. In our study, 849 elective blood samples were subjected to antibody screening by reagent 3 red cell screening panel and AS-negative blood samples were subjected to immediate saline phase crossmatch, and compatible units were issued to the patients. The same samples were subjected to AHG phase crossmatch for validation.

RESULTS

Among 14,705 elective requests for PRBC 849 patients had a history of transfusion or pregnancy. Of 849 patients, no case was found to be positive for antibody screening. Totally around 1028 PRBC units were saline crossmatched and totally 677 PRBC units were issued to the patients under T and S protocol. Not even a single case where AHG crossmatch was incompatible when antibody screening was negative. There was a perfect agreement between T and S method and AHG phase crossmatch. Crossmatch transfusion ratio was reduced from 2.1-1.5 with the implementation of T and S protocol.

CONCLUSION

This study validated and showed that there was a perfect agreement between T and S protocol and AHG phase crossmatch. All blood requests under elective protocol, the T and S method can be implemented for better utilization of technical workforce and better inventory management.