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When should antibody screening tests be done for recently transfused patients?
I A Shulman1, J M Nelson, R Nakayama
1Blood Bank and Transfusion Medicine Unit, Los Angeles County-University of Southern California Medical Center.
Transfusion
|January 1, 1990
Summary
The American Association of Blood Banks (AABB) updated transfusion testing standards, extending the blood sample window. This change may increase the risk of hemolytic transfusion reactions in some patients.
Area of Science:
- Transfusion Medicine
- Immunology
- Clinical Pathology
Background:
- The American Association of Blood Banks (AABB) mandates pretransfusion testing for blood samples.
- Standard G2.000 was amended in July 1988, changing the sample collection window from 2 to 3 days before transfusion.
- This amendment impacts recently transfused or pregnant patients.
Purpose of the Study:
- To estimate the risk associated with the amended AABB Standard G2.000.
- To evaluate the potential for delayed antibody detection under the new guideline.
Main Methods:
- Retrospective study of 60 patients who developed unexpected alloantibodies post-transfusion.
- Analysis of antibody detection timelines in relation to blood sample collection dates.
Main Results:
- Thirteen of 60 patients had newly detectable antibodies within 83 hours of a previously negative sample.
- The amended standard could delay antibody detection by up to 24 hours in some cases.
- An estimated 1 in 3000 transfused patients may be at risk for transfusion reactions.
Conclusions:
- The updated AABB standard for pretransfusion blood sample collection may pose a risk.
- Delayed antibody detection could lead to an increased incidence of hemolytic transfusion reactions.
- Further vigilance is recommended to mitigate risks associated with the revised standard.