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Variations in pretransfusion practices.

B J Padget¹, J L Hannon

¹Canadian Blood Services, 8249-114 Street, Edmonton, Alberta, Canada, T6G 2R8.

Immunohematology

|September 18, 2004

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Many clinical laboratories perform unnecessary pretransfusion tests, increasing costs without improving transfusion safety. Smaller labs often retain outdated practices, highlighting a need for process review and expert consultation.

Area of Science:

Transfusion Medicine
Clinical Laboratory Science
Healthcare Management

Background:

Pretransfusion testing aims to ensure transfusion safety and efficacy.
Recent evaluations suggest some traditional tests offer limited clinical value and are being phased out.
Variations in testing practices exist across different healthcare facilities.

Purpose of the Study:

To survey current pretransfusion testing practices in hospital transfusion services.
To analyze routine test practices in relation to facility size.
To identify potentially unnecessary or non-cost-effective tests being performed.

Main Methods:

A survey was distributed to 116 hospital transfusion services.
Ninety-one responses were analyzed, focusing on routine tests and facility size.

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Practices such as antibody screening, crossmatching, and specific component testing were examined.

Main Results:

Many smaller laboratories continue to perform tests like anti-A,B, DAT, and specific microscopic readings.
A notable percentage of facilities do not consistently perform Rh control with anti-D typing.
Survey data indicates widespread performance of tests that may not be necessary or cost-effective.

Conclusions:

Individual laboratory practices require periodic assessment for compliance, best practice, and cost-effectiveness.
Facilities, particularly smaller ones, should review processes to eliminate non-essential tests.
Consultation with larger institutions can guide smaller labs in optimizing pretransfusion testing protocols.