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CROSS MATCH

Cross matching is a critical procedure before blood transfusions to prevent serological incompatibilities between donor and recipient blood. It involves two types of tests: major cross match, which checks for antibodies in the recipient's serum against donor red cells, and minor cross match, which checks for antibodies in the donor's serum against recipient red cells. The procedure aims to ensure compatibility and avoid transfusion reactions, with results indicating whether transfusion is safe or not.

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46 views4 pages

CROSS MATCH

Cross matching is a critical procedure before blood transfusions to prevent serological incompatibilities between donor and recipient blood. It involves two types of tests: major cross match, which checks for antibodies in the recipient's serum against donor red cells, and minor cross match, which checks for antibodies in the donor's serum against recipient red cells. The procedure aims to ensure compatibility and avoid transfusion reactions, with results indicating whether transfusion is safe or not.

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mlskennam
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© © All Rights Reserved
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Obsa Mohammed ID NO 0722/14

Cross Matching:
 Cross matching is a procedure performed prior to transfusion of blood or blood products
to detect any serological incompatibilities in the blood of donor and recipient.
 Before a donor’s blood is transfused into a recipient, there should be no antigens or
antibodies in both, that would react with each other resulting in transfusion reaction.
 Cross matching is designed to prevent such transfusion reactions which may occur after
transfusion.
 Cross matching plays important role to detect:
Ü Most recipient antibodies directed against donor’s red blood cell antigens.
Ü Most donor antibodies directed against recipient’s red blood cell antigens.
Ü Major errors in ABO grouping, labeling and identification of donor and recipients.

Principle of Cross Matching


 Cross matching is based on the principle of serological detection of any clinically significant
irregular/unexpected antibodies in either donor or recipient’s blood.
 There are two types of cross matches:
1. Major Cross Match: It involves testing the donor’s red cells with recipient’s serum to
determine the presence of any antibody which may cause hemolysis or agglutination of
donor red cells. This is more important than minor cross match.
2. Minor Cross Match: It involves testing of donor’s plasma with recipient’s red cells to
determine the presence of any antibody which may cause hemolysis or agglutination of
recipient’s red cells.
Type Donor’s Recipient’s
Major Cross Match Red Cells Serum/Plasma
Minor Cross Match Serum/Plasma Red Cells

Procedure of Cross Matching

ƒ There are different methods for cross matching, as shown in table.


ƒ Among them most commonly used technique is Anti-human globulin (AHG) cross
match.

Method of Cross Match Detects Antibody of Type :


Saline Cross Match IgM
Albumin Cross Match IgG
Obsa Mohammed ID NO 0722/14

Anti-Human Globulin (AHG) Cross Match IgG

Major Cross Match


1. Prepare donor and recipient’s blood sample: Donor’s red cells and recipient’s
serum/plasma.
2. Prepare 3-5% saline cell suspension of red cells.
3. Label a test tube.
4. Add two drops of recipient’s serum and one drop of donor cell suspension.
5. Mix and incubate the tubes at 37 degree Celsius for about 60 minutes.
6. Decant the serum completely and wash the cells three times in saline.
7. Add two drops of Anti-human Globulin (AHG) and mix. Allow to stand at room
temperature for 5 minutes.
8. Centrifuge at 1500 rpm for 1 minute.
9. Observe macroscopically and microscopically for agglutination.
10. If macroscopic agglutination is not observed, transfer a small amount onto a glass slide
and examine for microscopic agglutination. Rouleaux is not an indication of

incompatibility.
Obsa Mohammed ID NO 0722/14

Minor Cross Match


1. Prepare donor and recipient’s blood sample: Recipient’s red cells and donor’s
serum/plasma.
2. Label a test tube.
3. Add two drops of donor’s serum and one drop of recipient’s cell suspension.
4. Mix and incubate the tubes at 37 degree Celsius for about 60 minutes.
5. Decant the serum completely and wash the cells three times in saline.
6. Add two drops of Anti-human Globulin (AHG) and mix. Allow to stand at room
temperature for 5 minutes.
7. Centrifuge at 1500 rpm for 1 minute.
8. Observe macroscopically and microscopically for agglutination.
9. If macroscopic agglutination is not observed, transfer a small amount onto a glass slide
and examine for microscopic agglutination. Rouleaux is not an indication of
incompatibility.
Obsa Mohammed ID NO 0722/14

Results and Interpretation

 Compatible donor and recipient blood should show no agglutination in both major and
minor cross match.
 Blood which shows incompatibility in major cross match should never be transfused,
because the large plasma volume of the recipient blood containing antibodies can destroy

the donor’s red cells easily.


 The minor incompatibility is less important because the donor’s serum which contains
the antibodies is diluted in the recipient’s own plasma, making the antibodies very dilute
and ineffective.

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