Procedure for blood transfusion

Blood grouping:

• The ABO and RhD groups of the patient are determined

Antibody screening:

• The patient’s serum is screened for atypical antibodies that may cause a significant reduction in the survival of the transfused RBCs
• The patient’s serum is tested against RBCs from at least 2 group O donors, expressing a wide range of RBC antigens, for detection of IgM RBC alloantibodies and IgG antibodies
• If there is a positive result, the blood group specificity of the antibody should be determined using a comprehensive panel of typed RBCs

Selection of donor blood and cross-matching:

• Donor blood of the same ABO and RhD group as the patient is selected

Cross-matching procedures:

Patients without atypical RBC antibodies:

• The full cross-match involves testing the patient’s serum against the donor RBCs suspended in saline in a direct agglutination test, and also using an indirect antiglobulin test

Patients with atypical RBC antibodies:

• Donor blood should be selected that lacks the relevant RBC antigen(s), as well as being the same ABO and RhD group as the patient
• A full cross-match should always be carried out