Routine Compatibility Testing Standards of the AABB as Applied to Compatibility Tests

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Abstract
The results of a blood group antibody survey carried out with the cooperation of 20 blood grouping laboratories are given. These results are used in a discussion of the antiglobulin phase of compatibility tests as they are outlined in the AABB Standards for a Blood Transfusion Service. A total of 37,961 irregular antibodies were reported. 37,811 or 99.6% of these antibodies could be detected by routine screening procedures using a pool of red cells from two or three selected donors, provided the pool contained the red cell antigens present in more than 2.5% of the Caucasian population. Only 145 or 0.4% of the reported antibodies would not be detected by such a routine screening test due to the fact that they react with red cell antigens present in 0.5% or less of the Caucasian population. Based on the antibody survey and a report of the antibodies responsible for 222 hemolytic transfusion reactions reported from 18 of the laboratories, a case is made for the use of routine antibody screening before all crossmatching procedures. If a carefully controlled screening test is negative it seems unnecessary to carry out the antiglobulin phase of the crossmatch. The serum or saline and high protein phases are still obligatory. If the screening test is positive, the antibody can be identified, making possible selection of suitable donor bloods before crossmatching is undertaken.

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