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Transfusion is vital for the patient if they have an illness, disease, medical condition or undergoing a surgery which loses blood or requires them to replace blood lost during an injury. Mistakes in cross-matching can occur if the wrong patient, IC or donor unit is given to the patient who requires transfusion. Pre-transfusion testing procedures consist of antibody screening, identification as well as cross-matching in blood transfusion establishments.
Clinically significant antibodies can cause haemolytic transfusion reactions. Antibody identification is critical for patients who require blood transfusions, it can detect the presence of any unsuspected antibodies moreover to ensure that the blood transfused is the compatible unit.
In cross-matching, the common things to check are the patient’s name, IC and the correct donor unit of blood is given to the patient. Severe adverse reactions may occur if the patient is given the wrong unit such as giving the wrong blood type or when a patient has alloantibodies or antibodies against certain blood antigens which can cause complications such as haemolytic transfusion reaction.
On the surface membrane of red blood cells, there are the ABO blood groups along with Rh antigens. To ensure that complications of transfusion do not occur, antibody screening is done to detect unexpected antibodies or alloantibodies.
When an agglutination is formed between antibodies and blood cell antigens in vivo, the production of alloantibodies will be formed. Alloimmunization happens after a second blood transfusion when antigens are recognized as foreign antigens. Examples of alloantibodies are Kell, Duffy, Kidd, MNS as well as Rh (D, C, E, d, c and e in the Fisher-race terminology).
When these are detected, a Coombs Antibody Test (CAT) is done to ensure that there is no reaction between the patient’s serum and the donor’s blood. When there is no suitable donor blood to give, an order of donor blood will be made from Blood Transfusion Service.
Other products such as fresh frozen plasma, cryoprecipitate as well as platelet unit must be checked as well to ensure that the correct unit is given to the correct patient to ensure that there are no complications. Certain patients such as patients with an immune disorder, unborn babies and inherited immune disorder, has special requirements such as irradiated products (blood and platelets) must be given to them to prevent transfusion-related graft versus host disease.
Hence, doing a pre-transfusion check between blood components and patient to avoid administering the wrong donor unit to the patient and complications to the patient as well as wasting unnecessary cost.
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