Evaluation of Incompatible Crossmatch at a Tertiary Care Blood Center

Introduction: Crossmatching is one of the basic tests of pretransfusion testing. Resolving problems in crossmatch should be carried out after proper planning and following departmental guidelines and SOPs (Standard Operating Procedures). The transfused RBCs will have acceptable Survival Rate, and there will be no significant destruction of recipient?s own RBCs. The aim of this study is to evaluate the incidence and causes of incompatible cross matches in patients. Material and Method: A total of 270 incompatible cross matches were reviewed out of total 85, 400 cross matches performed by column agglutination technique in a period of 1 year. A root cause analysis protocol was formulated to resolve the incompatibility, which would help to ensure safe transfusion to patients. Results: The overall incidence of incompatible cross matches was found to be 0.31%. The major cause for incompatibility was autoimmune hemolytic anemia (AIHA) (48%). Other causes of incompatibility were multiple transfusion (15%), Infections (10%), Hemolytic disease of newborn (10%), Presence of Allo-Antibody (10%) and DAT (Direct Agglutination Test) positive Donors (5%), Clerical error (2%). Incompatibility rate was higher in females (61%). Conclusion: The commonest Cause of Incompatibility was AIHA. Incompatible Crossmatch poses a challenge in the field of transfusion medicine. Root cause analysis is a systemic method for identifying all the contributing factors to a problem, so that the corrective action can be taken. A logical stepwise approach will enable the provision of safe transfusion.