Blood Bank and Pre-Transfusion Testing

This page is due for revision.

OVERVIEW

• blood products undergo a meticulous collection, preparation and testing process to minimise the risks of blood transfusion

COLLECTION

• donor selection
• testing of donor blood: groups (ABO, Rh), red cell antibodies and extended red cell antigen typing, infectious diseases, HLA typing, direct antiglobulin test
• processing into components and plasma derivatives

PREPARATION

• viral testing
• sterile handling
• leukodepletion
• blood component labeling
• compatibility labeling
• irradiation if required (against donor lymphocytes)

STORAGE

• RBC: 2-6°C for up to 42 days (35 days for pediatrics)
• Platelets: 20-24°C for up to 5 days with continuous gentle agitation
• FFP/Cryo: <-25°C for 12 months

PRE-TRANSFUSION TESTING

• meticulous attention to request form – request invalidated if any discrepancy
• group and hold/ type and screen: takes 45 min total

group or type

• ABO and Rh groups (forward and reverse typing tests) – takes 15 min

screen

• antibody screen (for non-ABO Abs) – if found takes hours to resolve
• checking for duplicate records of patient and comparing historic results with new
• valid for 3 days if previous transfusion or pregnant in past 3 months

Cross match (total 1-2 hours)

• electronic cross match only if negative Ab screen (takes 1 hour total, including G&H)
• serological cross match of patients plasma with donor cells if positive Ab screen (takes 2 hours total)

POST-REACTION TESTING

• haemovigilance activities
• notification and investigation of an adverse transfusion reaction

OTHER

• advice and information

References and links

References

Yazer MH. The blood bank “black box” debunked: pretransfusion testing explained. CMAJ. 2006 Jan 3;174(1):29-32. PMC1319340.

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