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Transfusion Blood Bank (Recipient) Testing

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Title: Transfusion Blood Bank (Recipient) Testing
Author: Caroline R. Alquist MD, PhD, D(ABHI) and Louise Helander MBBS
Publication: Clinics in Laboratory Medicine
Publisher: Elsevier Inc
Year: 2021
Language: English
Pages: 12
Format: PDF
File size: 250 KB
DOI: https://doi.org/10.1016/j.cll.2021.07.003
CBID: CBR259

Categories: Researches, Medical Researches Tag: Transfusion Blood Bank (Recipient) Testing

Description
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Pretransfusion and post-transfusion recipient testing are routine blood bank functions. This article presents a review of request and sample requirements, routine and extended typing and antibody evaluation, and post-transfusion circumstances requiring additional work-up. Although the regimented approach of blood banking fundamentals may be viewed as tedious, these steps are defined and designed to prevent potentially fatal ABO-incompatible transfusions and improve the overall safety of transfusion medicine patients.

Key points

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Transfusion request and sample label requirements are designed to prevent transfusion-associated morbidity and mortality.
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Pre-transfusion recipient testing for ABO/Rh, antibody status, and crossmatch compatibility is required for patient safety and remains a requisite function of the blood bank.
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Exceptions to routine pre-transfusion work-ups exist and include emergency product release and neonatal evaluations.
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Investigational post-transfusion testing of recipient samples is utilized in the work-ups of transfusion reactions, unexplained hemolysis, platelet refractoriness and transfusion-refractory anemia.

Introduction

Pretransfusion and post-transfusion recipient testing are routine, but nonetheless critical, blood bank functions. This article presents a review of request and sample requirements, routine and extended typing and antibody evaluation, and post-transfusion circumstances requiring additional work-up. Although the regimented approach of blood banking fundamentals may be viewed as tedious, these steps are defined to prevent potentially fatal ABO-incompatible transfusions and improve the overall safety for transfusion recipients.

Pretransfusion recipient samples

After receipt of a blood request and an intended recipient’s blood sample, blood bank staff must verify

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Request information
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Sample label information
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Sample type
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Sample age, appropriate to transfusion timing
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If historic ABO group is known

Request Information

Electronic medical records have allowed for transfusion medicine order standardization in most hospital systems that incorporate the required elements for component ordering. According to AABB Standards for Blood Banks and Transfusion Services , requests must contain

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Two independent patient identifiers
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Type and volume of requested component
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Special requirements (eg, leukoreduction, irradiation, washing, and volume reduction)
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Name of the authorized ordering health care provider