Is It Time to Switch from Conventional Coombs Crossmatching to the Type and Screen Protocol?

Area of Science:

• Transfusion Medicine
• Clinical Pathology
• Immunohaematology

Background:

• Routine pre-transfusion testing includes ABO grouping, Rh typing, and crossmatching.
• The Type and Screen (T&S) protocol is utilized in developed nations to enhance the survival of transfused red blood cells.
• This study evaluates the T&S protocol against conventional pre-transfusion testing for elective obstetrical and gynaecological procedures.

Purpose of the Study:

• To compare the safety, cost-effectiveness, and turnaround times (TATs) of the T&S protocol versus the traditional pre-transfusion testing protocol.
• To assess the clinical utility of the T&S protocol in identifying unexpected antibodies.
• To determine the impact of implementing the T&S protocol on hospital transfusion practices.

Main Methods:

• An observational study conducted in three phases over two years, involving 1,800 patients.
• Phase I: Traditional pre-transfusion testing and crossmatching (150 patients).
• Phase II: T&S protocol (150 patients).
• Phase III: Comparison of both protocols on 1,500 patients.

Main Results:

• The T&S protocol demonstrated 100% safety, comparable to the traditional method.
• The T&S protocol identified unexpected antibodies in 0.4% of cases, which might have been missed otherwise.
• No significant cost difference was observed between the T&S and traditional crossmatching protocols.
• Utilizing solely the T&S protocol resulted in a 30% time saving for technologists.

Conclusions:

• The T&S protocol enhances hospital transfusion practices by providing faster and safer blood supply.
• The T&S protocol is a valuable tool for pre-transfusion testing, improving efficiency and safety.
• Coombs crossmatching may be considered more traditional than essential in many pre-transfusion scenarios.