[Phenomenon of indirect isoserological incompatibility in experimental transfusion research and its clinical...

It has been established in experiments on dogs exposed to blood transfusions that if the animals are screened according to the cross-matching testing system and show as a result the lack of red blood cell agglutination, this does not provide evidence in favour of their complete isoserological compatibility. To confirm whether the animals are compatible, it is required to carry out 7 to 8 tests with other species. If the tests reveal red blood cell agglutination, blood transfusion is characterized by demonstrable isoserological incompatibility and the recipient dies. If the cross-matching with the other animals of the group is accompanied by red blood cell agglutination but the latter is absent in the testing of a particular animal pair, such a condition is designated as "indirect" incompatibility, since hemotransfusion in this animal pair is characterized by the manifestations of incompatibility. However, it is not so pronounced and the recipient can be saved by intensive care. The authors conclude that isoserological incompatibility has different grades of intensity and offer methods for the screening of animals for simulation of graver and facilitated grades of incompatibility. It is assumed that the clinical transfusiology also has grades of the severity of hemotransfusion-induced conflicts, particularly in cardiosurgery. The use of large amounts of donor's blood for extracorporeal circulation and making for large blood losses is very likely to entail isoserological incompatibility cases which may remain unrecognized because of the gravity of surgical intervention, provoking at the same time the postoperative acute heart failure.