Antibody Detection & Crossmatch

The goal of antibody screening is to detect unexpected clinically significant red cell antibodies. In general, clinically significant antibodies are antibodies known to have caused Hemolytic Disease of the Newborn (HDN), hemolytic transfusion reaction, or shortened survival of transfused red blood cells.

There are several ways to detect red cell antibodies. Each hospital or region determines its method of antibody screening and compatibility testing. Regardless of the method or enhancement media used, the method must be capable of detecting clinically significant antibodies, which requires that the antibody screen method include a 37oC incubation with reagent red cells that have not been pooled followed by an Indirect Antiglobulin Test (IAT), or an alternate method that has documented capability to provide comparable sensitivity.

Methods of Antibody Detection & Crossmatch

1. Indirect Antiglobulin Test
   - LISS
   - PEG
2. MTS™ GEL Test (Gel-IAT)
3. Solid Phase Adherence Assay (SPAA)

Whenever the antibody screen is found to be positive, an antibody investigation must be performed.

Crossmatch Methods

1. Immediate Spin Crossmatch

   The Immediate Spin (IS) crossmatch is performed only after an antibody screen is done and found to be negative on a current specimen. The patient should have no history of clinically significant antibodies.

   The immediate spin crossmatch is meant to detect ABO incompatibility. It can also detect cold reactive (clinically insignificant) antibodies that react at room temperature (RT).

   If the patient's expected ABO antibodies are not reactive or weak at immediate spin,donor units should be ABO confirmed prior to testing with this method.

2. Computer or Electronic Crossmatch

 Further Reading