Abdulahi Salad Gutale

1. Pretransfusion and Compatibility Testing
Arsham Haile
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2. Pretransfusion requirements
1. Informed consent is one of the cornerstones of transfusion
safety. In order for patients to give informed consent, they must
first be educated about the risks and benefits of transfusion, as
well as any alternatives that may be available to them.
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3. Pretransfusion requirements
 Consent is considered informed when a description of the
risks, benefits, and viable treatment alternatives are provided
in language the patient or the legal representative can
comprehend.
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4. Pretransfusion requirements
 Regardless of when consent is obtained, patients must have
the opportunity to ask questions and must be given the right
to accept or refuse transfusion.
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5. Pretransfusion requirements
 If the patient is unable to give consent due to incapacitation
or inability to comprehend, the legal medical next of kin
must be educated before giving consent (or denying it for
religious or other beliefs).
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6. Pretransfusion requirements
2. Requests for Blood Components: Physicians or other
authorized health professionals are responsible for ordering
blood components for transfusion. Consideration must be
given to the following when blood components are ordered:
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7. Pretransfusion requirements
2. Requests for Blood Components:
 The name of the physician placing the order must be
indicated.
 Orders should be placed to ensure sufficient time to perform
complete testing.
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8. Pretransfusion requirements
2. Requests for Blood Components:
 Requests should include enough clinical information and
patient history to ensure that appropriate products will be
provided.
 Requests must include the number and type(s) of component(s)
required
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9. Pretransfusion requirements
2. Requests for Blood Components:
 There should be sufficient information on the request form to
allow adequate identification of the patient.
 At minimum, there must be two independent patient
identifiers on the request for transfusion.
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CHECKPOINT
1. What is the minimum number of patient identifiers
that must be included on a request for transfusion?
A. one
b. Two
C. Three
d. four

11. Pretransfusion requirements
3. Red Blood Cells: Most pretransfusion sample collection and
testing requirements are intended to reduce the risks associated
with transfusing incompatible red blood cells. Transfusion of
incompatible red blood cells can result in a hemolytic
transfusion reaction that may be life-threatening.
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12. Pretransfusion requirements
3. Red Blood Cells:
a) Specimen Collection
 Specimen collection is the first critical step in ensuring positive
patient and sample identification.
 Patient identification may be done using eye-readable or
machine-readable information or a combination of both.
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14. Pretransfusion requirements
3. Red Blood Cells:
b) Patient History
 Patient history is of particular importance when transfusing red
blood cells.
 Patient history is an important source of information for previous
pretransfusion testing results.
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CHECKPOINT
2. List two ways that exposure to foreign red blood
cell antigens can occur.

16. Pretransfusion requirements
3. Red Blood Cells:
c) Mandatory tests
 At minimum, pretransfusion testing for red blood cell transfusion
must include the following three tests that comprise the minimum
required components of the immunohematology test known as type
and screen (T & S).
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17. Pretransfusion requirements
3. Red Blood Cells:
d) Reflex tests
 Reflex tests are automatically performed as a result of inconclusive
or unexpected results found during mandatory testing.
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18. Pretransfusion requirements
3. Red Blood Cells:
e) Compatibility testing
 Compatibility testing, also known as a crossmatch, is performed
prior to release of red blood cells for transfusion.
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19. Pretransfusion requirements
3. Red Blood Cells:
f) Considerations for neonates
 The ABO group of the neonate is determined only by the forward typing.
 In order to reduce the risk of a transfusion reaction due to passive maternal
anti-A or anti-B, many facilities have policies in place to
transfuse only group O red blood cells to neonates.
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20. Pretransfusion requirements
3. Red Blood Cells:
g) Specimen retention
 From each RBC unit tested must be retained by the laboratory for a minimum
of 7 days after transfusion.
 In the event of a patient transfusion reaction, these samples are required, along
with a post-transfusion patient specimen, for investigation into the cause of
the reaction
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21. Pretransfusion requirements
4. Platelets: The critical pretransfusion test for platelet
transfusion is ABO typing.
 Minor ABO incompatibility
Major ABO incompatibility
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23. Pretransfusion requirements
5. Plasma Products: In the case of plasma products, only minor
ABO compatibility is of concern because these products contain
no cells and therefore no ABH antigens.
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24. Pretransfusion requirements
6. Fractionation Products: Generally, administration of
fractionated products, comprised of plasma proteins, does not
necessitate pretransfusion testing.
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25. Pretransfusion Tests for recipient 25
I. ABO typing/grouping
II. Rh(D) typing
III.Antibody screening and identification
IV.Crossmatching
V. DAT/direct antiglobulin testing

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CHECKPOINT
3. Solid phase technique

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