Guidelines for pre-transfusion compatibility procedures in blood transfusion laboratories

1. INTRODUCTION1.1. Purpose of pre-transfusion guidelines.Technicalerrors and/or inappropriate test systems or administrativeerrors may result in immediate and delayed haemolytictransfusion reactions. The purpose of these guidelines,which replace those previously published (BCSH,1991a), is to define organizational, documentation andtechnical procedures undertaken in hospital or RegionalTransfusion Centre laboratories prior to blood transfu-sion.1.2. Elements in pre-transfusion testing1.2.1. ABO and RhD grouping of the recipient1.2.2. Antibody screen of the recipient, or mother in thecase of neonatal transfusion, which in the event of apositive screen, should be followed by antibody identi-fication.1.2.3. A computer or manual check of records. Thesethree elements constitute a group and screen.1.2.4. Donor red cell selection and crossmatching.1.2.5. In certain emergencies, the recipient’s need forimmediate red cell support may dictate that pre-transfu-sion testing is abbreviated.1.3. Clinical significance of red cell antibodies1.3.1. Clinically significant antibodies are those whichare capable of giving rise to accelerated destruction ofred cells bearing the relevant antigen.1.3.2. Anti-A, anti-B and anti-A,B must always beregarded to be of clinical significance.1.3.3. With few exceptions, irregular antibodies whichare potentially clinically significant are only those whichare reactive in the indirect antiglobulin test (IAT),performed strictly at 37