Crossmatch incompatibility, indwelling experience from a single center, Bangladesh

Abstract

Background and Objectives: Crossmatch incompatibility among the blood donor and recipient is common. The cause for which may vary in patients despite rational transfusion practices. Provision of appropriate blood components can also be complicated by transfusion, pregnancy, exposure to drug, or various diseases. Therefore, the reasons for assessing the crossmatching incompatibility are important in transfusion safety. The present study was conducted to determine the prevalence of crossmatch incompatibility in this region and the reasons behind it. Methods: In this retrospective observational study, 32,403 crossmatch data were reviewed from crossmatch register between July 2018 and June 2019. Crossmatch was performed with both saline and antihuman globulin method. Incompatible crossmatch was evaluated further. Results: About 0.15% (n = 50) of patients showed crossmatch incompatibility: of this, 66% were female and 34% male. About 80% of crossmatch incompatibility was associated with multiple transfusions; of these, direct antiglobulin test (DAT) was positive in 78% (n = 39) and indirect antiglobulin test (IAT)/antibody screen was positive in 68% (n = 34) of patients. Both DAT and IAT were positive in 46% (n = 23). Further antibody identification was done. Conclusion: This study highlights the need for introducing antibody screening before compatibility testing, especially in multitransfused individuals.

Keywords

• allo- and autoimmunization
• incompatible transfusion direct antiglobulin test
• indirect antiglobulin test