Guidelines for pre-transfusion compatibility procedures in blood transfusion laboratories

1.1. Purpose of pre-transfusion guidelines. Technical errors and/or inappropriate test systems or administrative errors may result in immediate and delayed haemolytic transfusion reactions. The purpose of these guidelines, which replace those previously published (BCSH, 1991a), is to define organizational, documentation and technical procedures undertaken in hospital or Regional Transfusion Centre laboratories prior to blood transfusion. 1.2. Elements in pre-transfusion testing 1.2.1. ABO and RhD grouping of the recipient 1.2.2. Antibody screen of the recipient, or mother in the case of neonatal transfusion, which in the event of a positive screen, should be followed by antibody identification. 1.2.3. A computer or manual check of records. These three 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 for immediate red cell support may dictate that pretransfusion testing is abbreviated. 1.3. Clinical significance of red cell antibodies 1.3.1. Clinically significant antibodies are those which are capable of giving rise to accelerated destruction of red cells bearing the relevant antigen. 1.3.2. Anti-A, anti-B and anti-A,B must always be regarded to be of clinical significance. 1.3.3. With few exceptions, irregular antibodies which are potentially clinically significant are only those