Present Status of Emergency Blood Transfusion and System of Urgent Pretransfusion Cross-Match Tests in Kansai Medical University Hospital

Abstract

Present status of the emergency blood transfusion in our hospital, our manual for the pretransfusion cross-match test, and also results of several fundamental studies are reported here. 1) Truely urgent cases in which the urgent blood transfusion had been started before complete cross-match tests, were only 0. 1 0. 3% of all red blood cell transfusion cases, while sub-urgent cases in which the combination of saline-> LISS-> Coombs' test could be completed before starting of blood transfusion, were 0. 6-0. 8% of them, from Apr. , 1982 to Mar. , 1984. The frequency of the urgent cross-match tests in our division seems to be relatively low. Our communication system between clinical doctors and our blood transfusion unit adopted Mar. , 1980 might have significantly contributed to this low frequency. 2) The résumé of our manual for urgent pretransfusion cross-match test made Mar. , 1980, consists of three combinations of cross-match tests. 1. In cases with deferrable time being less than 15 minutes, we adopt the combination of saline-> albumin-> Coombs' test. The blood transfusion can be begun from any step of these tests after the patient's red blood cell antigen group as to ABO and Rh (D) has been identified. Still, we keep on testing, and any abnormal results, if obtained, are reported to the doctor in charge. 2. In cases with it of 15 to 40 minutes, the combination of saline-> LISS-> Coombs' test, 3. In cases with it of 40 to 60 minutes, the combination of saline-> albumin (PBA, 37°C, 20 min. ) -> Coombs' test is adopted. In such cases as the screening test for unexpected antibodies could not been completed, the screening test using bromelin is usually carried out in parallel with these cross-match tests. A manual of tests and a communication system such as ours for urgent pretransfusion, at least, must be standardized all over the country, in order to secure the safety of urgent blood transfusion.