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GXM & GSH

Compatibility testing

Prevent haemolysis

Blood grouping

Reagents/ equipments Anti A, B, AB (direct grouping) Blood from recipient (cells, serum) Tile, Test tubes Centrifuge Known cells – O, A, B (indirect grouping)

Principle Antigen-antibody reaction causes RBC agglutination

Cross Matching (GXM)

To transfuse compatible red cells to patients Principle Red cells from donor (same ABO, RhD)
To transfuse compatible red cells to patients
Principle
Red cells from donor (same ABO, RhD) tested against recipient (patient) serum
Agglutination – incompatible donor red cells
Methods
Detecting clinically significant IgM antibodies (cold) – saline in room temperature
Detecting clinically
significant
IgM, IgG antibodies (warm) – saline 37°C
Detecting immune antibodies (mainly IgG) – indirect antiglobulin test (AHG test)
at 37°C
Cross matching test
Red cell antibodies to
Minor blood groups
Lewis, Duffy, Kell antigens (on red cell surface)
Major blood groups
ABO, Rhesus D antigen (very immunogenic)
Development of Red cell antibodies by
Naturally
Immune me chanisms
Red cell agglutination (incompatible donor) – Test tube, Blood film

Antiglobulin test (Coombs test)

AHG (Antihuman globulin) – produced via animals by injection of human globulin, compleme nt, immunoglobulin
AHG (Antihuman globulin) – produced via animals by injection of human globulin,
compleme nt, immunoglobulin
AHG + Human RBC (coated with Ig antibody) or complement
Agglutination – indicate +ve test
Donor’s blood is not compatible/ safe for transfusion
AHG enhance red cell agglutination (red cells coated by antibodies)

Group Screen Hold (GSH)

Group

Screen

Hold

ABO, Rhesus grouping of patient’s blood

Red blood cell antibody screening

Keep screened sample until need arise

 

Patient’s serum tested against reagent red cells (known red cell antigens)

Will not be cross- matched until needed

 

Using known red cell antigens (red cell panel I, II, III) – indirect Coomb’s test

 
 

+ve result will show agglutination (indicate patient has specific antibody(s) to antigen(s))

 

Results of antibody screening

 

Postive (+ve)

Negative (-ve)

Identify antibody – type of red cell antibody

When blood is required, cross- matching will be performed (saline, room temperature)

Compatible blood will be supplied after full cross-matching & typed (negative for antigento particular antibody)

Blood issued as soon as neede d Full cross-matched proceed in lab Blood is taken even when procedure is not finished

Advantages of GSH ↓ Blood stock (for blood cross-matching - not needed for blood transfusion) ↓ Blood wastage & Expiry date Safe blood is supplied to patients (equal to doing GXM) Blood is delivered ASAP when needed

Indications for GSH Cases of elective surgery (chances of not using is ↑ than using blood) Blood request is not more than 2 units Adult cases only Negative for red cell antibody screening No history of recent blood transfusion

Gel card method GXM & GSH AHG is pre-added in gel card column Agglutination show
Gel card method
GXM & GSH
AHG is pre-added in gel card column
Agglutination show as layer of red cells on top of gel column