Obsolete Immunohematologic Tests
During the past 20 years, many serological tests have been eliminated or abbreviated because they were found to enhance patient safety. Examples include:
- Minor crossmatch
- Antiglobulin crossmatch unless antibody screen is positive or patient has a history of clinically significant antibody
- Auto-control (DAT) for pretransfusion testing
- Weak D (Du) testing on everybody except cord bloods
- Multiple antibody panels under different conditions
- Cold antibody screens for open heart surgery
- Reduced number of repeat panels on patients with known antibody
- Antigen typing for clinically insignificant antibodies (e.g. Le, M, P)
- R-set instead of full panel for positive antibody screens in patients who may have received Rh immune globulin
- Elutions unless transfused within last 3 months
- Anti-A, and anti-B testing to confirm group O units
- Repeat Rh typing of Rh positive units (only confirm Rh negative units)
- Direct antiglobulin tests only on cord blood from infants born to Rh negative women.
- Elutions on cord blood with positive DAT
Laboratory workload continues to increase and transfusion services are increasingly being asked to reduce their operational costs. Unnecessary testing that does not contribute to transfusion safety should be eliminated.
