Nearly two decades using the check-type to prevent ABO incompatible transfusions: one institution's experience

Area of Science:

• Transfusion Medicine
• Patient Safety
• Laboratory Hematology

Background:

• Miscalibrated or miscollected samples, known as wrong blood in tube (WBIT) errors, pose a significant risk for ABO-incompatible transfusions.
• Existing protocols often rely on historical blood type data for WBIT detection, but this is not always available.
• A check-type (CT) system, involving a second independently drawn sample, was implemented for non-group O patients requiring transfusion.

Purpose of the Study:

• To evaluate the effectiveness of the check-type (CT) system in detecting wrong blood in tube (WBIT) errors.
• To determine the rate of WBIT errors over a 17-year period.
• To assess the role of CT in preventing ABO-incompatible transfusions.

Main Methods:

• A 17-year retrospective analysis of WBIT errors was conducted.
• Detection methods included comparison with historic blood types, the CT system, and other means.
• The number of CTs performed and WBIT errors detected were recorded.

Main Results:

• Over 17 years, 94 WBIT errors were identified.
• The CT system detected 7% of WBIT errors and averted 5 potential ABO-incompatible transfusions.
• The corrected WBIT error rate was 1 in 3,713 for samples tested between 2000-2003.

Conclusions:

• The check-type (CT) system is an effective method for creating a historic blood type, crucial for detecting WBIT errors.
• Comparing current blood typing results with historic data, supplemented by CT, helps avoid ABO-incompatible transfusions.
• The study highlights the importance of robust WBIT detection strategies in transfusion services.