Utility of type and screen policy for pretransfusion compatibility testing at an urban level Ι apex trauma center

Objective: Type and crossmatch (TC) policy is the most common approach for pretransfusion compatibility testing prior to issue of blood for transfusion. As it involvesreserving of the blood units (usually up to ۷۲ hours) prior to issue or un-reserving, it can leadto excessive blood cross matching, inventory management problems, undue workload,blood outdating and reagent wastage. Type and screen (TS) policy is an alternativeapproach without the need to cross match and reserve blood units prior to issue. The aimof the current study was to retrospectively assess the impact of the implementation of TSpolicy for pre-transfusion compatibility testing on blood transfusion services at an urbanlevel Ι trauma center.Methods: The study was done in two phases in the Department of Transfusion Medicineat Jai Prakash Narayan Apex Trauma Center AIIMS, New Delhi, India. Transfusion data wascollected and compared during two phases: initial phase (Oct ۲۰۱۶-Mar ۲۰۱۷) of TC policyand second phase (Apr ۲۰۱۷-Sept ۲۰۱۷) of TS policy.Results: TS policy resulted in the reduction of C:T ratio from ۵.۳ to ۱.۹. Transfusionprobability increased to ۲۹.۵% during TS policy from ۲۳.۶% during TC policy. Issuable stockindex (ISI) also showed reduction from ۱۲.۵ to ۱۱.۴ after TS policy. Wastage as percentageof issue (WAPI) was reduced from ۲.۳% (TC) to ۱.۳% (TS). TS policy also led to reductionin expenses incurred on pre-transfusion compatibility testing by ۳۵%. No hemolytictransfusion reaction was reported during the study.Conclusion: TS policy was found to be a safe and an efficient alternative approach to TCpolicy for pre-transfusion compatibility at our center. We recommend the implementationof TS policy, but each center should first assess its feasibility based on patient population,blood bank resources and staff knowledge

کلیدواژه ها:

Blood typing ، crossmatching ، type and screen ، crossmatch to transfusion ratio