Abstract
For many years, the crossmatch has served as the pretransfusion determinant of compatibility between recipient and donor. The majority of units of blood crossmatched for elective surgical procedures are not used and many antibodies detected in the crossmatch are not of clinical significance. Motivated by the need to eliminate testing that does not significantly enhance the provision of a safe product, the necessity for doing crossmatches has been questioned. Recent studies indicate that the substitution of the “group-and-screen” for the complete crossmatch represents an acceptable approach to the provision of blood for many elective surgical procedures. The benefit of this approach is significant: blood is utilized more efficiently and the blood bank has a reduction in workload. The risk is very minimal: only one of several thousand transfusions will be given to patients with previously undetected alloanti-bodies; and recent evidence indicates that such incompatibilities have little clinical impact.
Résumé
Depuis plusieurs années l’épreuve de compatibilité complète a servi à déterminer la compatibilité entre le receveur et le donneur avant la transfusion. La majorité des unités de sang pour laquelle on fait l’épreuve de compatibilité complète pour chirurgie élective ne sont pas utilisées et plusieurs anticorps ainsi détectés n’ont pas de signification clinique.
Cherchant à éliminer les tests qui n’augmentent pas de façon significative la sécurité des produits sanguins, la nécessité de l’épreuve de compatibilité complète a été remise en question. Des études récentes indiquent que lu détermination du groupe sanguin et la recherche d’anticorps au lieu de l’épreuve de compatibilité complète constituent une alternative acceptable pour plusieurs interventions électives.
Cette approche permet l’utilisation plus rationnelle du sang et réduit le travail de la banque de sang. Le risque est minimum, car une transfusion sur plusieurs milliers sera donnée à un patient ayant des alloanticorps non détectés auparavant et des études récentes montrent que ces incompatibilités ont peu de conséquences cliniques.
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Kelton, J.G., Perrault, R.A. & Blajchman, M.A. Substitution of the “group-and-screen” for the full crossmatch in elective operations. Can Anaesth Soc J 30, 641–645 (1983). https://doi.org/10.1007/BF03015236
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DOI: https://doi.org/10.1007/BF03015236