Compatibility testing consists of a variety of tests performed before transfusion to ensure safety of who?
Recipient
________ lacks fibrin clots which can cause false agglutination
plasma
_________ may inactivate complement, some antibodies may not be detected.
plasma
samples for crossmatch should not be more than ____ hours old.
72 hrs
________ specimens can mast true hemolysis of antigen-anitbody complexes, reject and redraw.
hemolyzed
for Crossmatch, patient and donor RBCs should be saline washed how many times?
once
for what patients should you use serum/plasma of mother and infant for initial testing?
<4 months old
Why do you use serum from mother for patients <4 months old?
blood must be compatible with maternal antibodies that may have crossed placenta
What is the form number for the Blood request form?
SF 518
What is the secion of the SF 518 that contains the blood component requested, physician's name, and diagnosis or operative procedure and date and time of drawing?
section 1
in what block of the SF 518 does the person drawing blood sign?
section 1
what three persons can sign the SF 518?
MO
RN
MLT
Information on specimen and SF 518 must __________.
agree exactly
what should be done if information on specimen and SF 518 does not agree?
redraw patient
these may be undetectable now due to decreasing titer or dosage?
previous identified antibody
this should be checked to confirm previous serological history.
transfusion record review
This test uses group O human RBC to detect unexpected (alloantibodies) NON-ABO antibodes in patient serum.
Antibody screen (IAT)
if antibody is identified what should be done to verify corresponding antigen?
phenotype patient
_________ negative donor units should only be used.
antigen
Crossmatch uses recipient ________ and donor ______.
recipient serum
donor RBC
Do not used donor units if partially ________, color is _______ or ________ or if plasma shows _________.
clotted
purplish
brownish
hemolysis
inadequate sealing or closure of tubings or inadequate cleaning of venipuncture site can cause what?
contamination
what is the common unsuspected bacteria seen in donor units?
yersinia enterocolitica
units appearing contaminated must be __________ and __________.
quarantined
investigated
true or false
matching of donor and recipient with respect to other blood group antigens is NOT necessary unless the recipient has additional serum antibodes.
true
Donor units MUST lack _______ corresponding to recipient Ab.
antigen
Fresh Frozen Plasma should be compatible with patient's _____.
RBCs
for what type of patients are there NO acceptable FFP alternatives?
neonates
who is the universal donor for fressh frozen plasma?
AB
who is the universal recipient for FFP?
O
for what blood products are all ABO groups acceptable?
Platelet concentrate
Single donor cryoprecipitate
_________ donor units are to be used when patients own blood type not available.
alternate
for what blood product is there no alternative?
whole blood
the major factor in determining alternate ABO group is what?
recipient's ABO antibodies
What are four indications for transfusion of Non-Group-Specific blood products?
Massive bleeding
trauma
DIC
blood group shortage
What are alternate Rh choices for Rh positive patient?
Rh pos
Rh neg
When can Rh negative patients receive Rh positive units not producing anti-D?
Emergency
What are the two patients who can be converted to Rh positive?
male patients
women beyond child bearing age
Switching ABO groups is a ___________ problem.
temporary
true or false
it is better to give Rh negative patients an Rh negative alternate compatible blood group becuase switching ABO groups is a temporary problem.
true
Production of Anti-D due to giving Rh positive is a _________ problem.
permanent
what percent of D-negative persons who receive a D-positive transfusion are expected to develop anti-D.
more than 80%
This test detects the presence of clinically significant unexpected Abs.
Antibody Screen in Compatibility Testing
what phase of crossmatch may be omitted if there is a negative Ab screen and no prior record of Abs.
AHG
true or false
Crossmatch can detect all clinically significant Abs.
false
what is the last blood bank test done prior to patient receiving transfusion?
Crossmatch
This detects recipient antibodies that will react with donor RBC antigens.
Crossmatch
Crossmatch will detect _____ ABO grouping errors.
some
Crossmatch will detect Rh D typing errors if what?
patient's serum contains Anti-D
What are two situations where crossmatch will not detect all atypical antibodies in recipient's serum?
antibody titer too low
donor cells may not contain corresponding antigen
True or false
crossmatch will not prevent recipient from forming antibodies?
true
Crossmatch must be capable of detecting what three types of antibodies?
hemolyzing
agglutinating
coating
Computer crossmatch standards are set by who?
AABB
for computer corssmatch patient must have hhow many concordant ABO/Rh types?
two
true or false
to perform a computer crossmatch, current antibody screen must be nonreactive and no history of antibodies.
true
what are the two poteniating media used for crossmatch.
albumin
LISS
What is the ratio for recipient serum and Donor RBC suspension for crossmatch.
2:1
What phase of crossmatch will detect IgG antibodies and some Rh system antibodies?
37oC/ albumin or LISS phase
how many drops of potentiator should be added to recipient serum and donor RBC suspension for crossmatch?
two
check cells must have what result?
positive
Patients with _________ antibodies may show positive reactions in all phases and temps.
multiple
if there is a positve result in crossmatch what should be done?
identify antibodies and crossmatch units lacking the antigen
What are the three cold autoantibodies?
Anti-I (most common)
Anti-H
Anti-IH
what is the most common cold autoantibody?
Anti-I
Cold autoantibody problem Must be solved, why?
may be masking presence of other alloantibodies
this technique is used to eliminate the activity of anti-I.
prewarm
if patient has not been recently transfused, this technique will remove the Anti-I from the serum.
cold autoadsorption
Adsorbed serum should be used for what three tests?
ABO reverse grouping
Crossmatching
antibody studies
This protein problem is commonly seen in multiple myeloma patients.
rouleaux
Rouleaux is not seen in what phase due to serum being washed away.
AHG
how is rouleaux formation resolved?
saline replacement
Albumin/LISS is stabilized with what?
Sodium Caprylate Serum
This will agglutinate all RBCs suspended in albumin/LISS that has caprylate?
anti-Caprylate
how is albumin agglutinating phenomenon resolved in crossmatch?
repeat crossmatch with non caprylate albumin
if a patient has warm autoantibodies present what other test will be positive?
DAT (direct coombs)
Warm autoantibodies are most often directed against what antigens?
Rh system antigens
If there are not units lacking antigen to patient's antibody _________ crossmatch may be needed to determine the least incompatible unit.
titration
in titration crossmatch what are the units of preference?
units compatible at lower dilutions
Bacterial contamination may causes a false positve because red cells carry this antigen which reacts with human sera?
T antigen
Sialic acid removal by enzymes exposes this antigen in vivo or in vitro.
T antigen
What are the four bacterial contaminants associated with Z-neuraminidase, which can cause T-polyagglutination?
Clostridia
E. coli
V. cholerae
Influenza viruses
what are two false negative results which are actually misinterpreted positive results?
hemolysis
weak agglutination
no agglutination/hemolysis in any phase indicates what result in crossmatch?
compatible
what three things can cause negative reaction on check cells?
poor washing
neutralization
AHG not added
This indicates serological incompatibility between recipient and donor unit.
agglutination/hemolysis in any phase
is alternate crossmatching procedure is to be used only in emergency.
random crossmatch
What three things should be rechecked for donors and recipients if there is an incompatible crossmatch workup?
ID of specimens
ABO
Rh
uncrossmatched blood should be used only in what situations?
emergency
what blood type should be used for uncrossmatched blood?
O neg
who assumes responsibility for uncrossmatched blood?
physician
uncrossmatched blood units must be labeled _________.
"uncrossmatched"
true or false
uncrossmatched blood should be crossmatched after the fact
true
What section of the SF 518 must be filled out completely with compatibility testing results?
section II
What is the expiration time for crossmatch?
72 hours
Recipient specimen and dnor sample for crossmatch should be saved for ___ days post transfusion at 1-6oC.
7
Author
corbin19
ID
39599
Card Set
Compatibility Testing (Crossmatch) 8.8
Description
Compatibility Testing (Crossmatch) Blood Bank Unit 8.8