UNCROSSED BLOOD
TEGUH TRIYONO
Dept. of Clinical Pathology
Faculty of Medicine, Gadjah Mada University
RSUP dr. Sardjito
Yogyakarta, Indonesia
Blood Group Antibody
Blood group Anti-A Anti-B
A - IgG>
IgM>>>
B IgG>
IgM>>> -
O IgG>>> IgG>>>
Transfusion With O Donors
PATIENT MAJOR MINOR
Blood group
A COMPATIBLE INCOMPATIBLE
B COMPATIBLE INCOMPATIBLE
O COMPATIBLE COMPATIBLE
AB COMPATIBLE INCOMPATIBLE
O Transfusion
AHTR
DHTR
The responsible hospital service or location for the emergency transfusions
and distribution of 45-day all-cause mortality. ETU = emergency trauma
unit;OB = obstetrics. ( ) Day 45 mortality; ( ) episodes.
Trends in the serum biochemical markers of haemolysis following cWB transfusion in non-group
O and group O recipients. Shown are the median and the interquartile range for (a) haptoglobin,
(b) total bilirubin, (c) lactate dehydrogenase (LDH), (d) creatinine and (e) serum potassium. e
grey shaded areas represent the reference ranges for each analyte. e only signi cant di erence (*)
between the non-group O and group O cWB recipients in any of these analytes was the median
serum total bilirubin on day 0.
HAPTOGLOBIN
TOT BILIRUBIN
LDH
CREATININE
NA
Seheult. Transfusion Medicine, 2017, 27, 30–35
Summary of Data for Recipients of
Incompatible ER RBCs
Goodell. Am J Clin Pathol 2010;134:202-206
• transfusion of ER RBCs before completion of
routine blood bank testing carries a low but real
risk of receipt of antigen-incompatible RBCs
(1.5% of ER units or 2.6% of ER episodes) and
non-ABO alloantibody-mediated HTRs (0.1% of
ER units or 0.4% ER episodes).
• This overall risk is low, posing an acceptable risk
in the urgent transfusion setting.
Goodell. Am J Clin Pathol 2010;134:202-206
Yazer. Anesthesiology 2018; 128:650-6
Uncrossmatched erythrocytes should not be denied to an acutely
hemorrhaging or severely anemic unstable patient if the results of
pretransfusion testing are not available when the patient requires an
urgent transfusion.
Overall risk of hemolysis following the transfusion of uncrossmatched
erythrocytes to patients needing an emergency transfusion of 0.1%,
however, uncrossmatched erythrocytes should not be used in otherwise
stable patients who can wait until crossmatched units become available.
RhD − erythrocytes (crossmatched or uncrossmatched) should be
preferentially administered to women of childbearing potential whose
RhD type is unknown, or to patients where making this determination is
difficult; all others, including males, should receive RhD+ erythrocytes.
Yazer. Anesthesiology 2018; 128:650-6
• The risk of a RhD− patient forming anti-D after receipt of RhD+
erythrocytes is relatively small, preserve the inventory of RhD−
erythrocytes for females of childbearing potential (typically de ned as ≤
50 yr old).
• The risk of forming unexpected antibodies after receipt of
uncrossmatched erythrocytes should be identical to that after receipt
of crossmatched erythrocytes.
• Emerging evidence suggests that it is safe to transfuse group A plasma
and group O WB to traumatically injured recipients of unknown ABO
group.
• Group O RBCs can continue to be used safely
in cases of emergency transfusion, which pre-
cludes pretransfusion compatibility testing in
all patient populations.
Mulay et al. Transfusion. Volume 53, July 2013
Biochemical markers of hemolysis in a subset of non–group O ( , 3 or 4 units, n 5 23) and group O
(, 3 or 4 units,n 5 14) recipients of between 3 and 4 units of cold-stored LTOWB.
There were no significant differences between the non–group O and
group O cold-stored LTOWB recipients for any of the analytes measured at any time point.
HAPTOGLOBIN
TOT BILIRUBIN
LDH
CREATININ
POTASSIUM
Seheult.Transfusion. Volume 58, October 2018
• Administration of ≤2 units of cWB in civilian
trauma resuscitation was not associated with
clinically significant changes in laboratory
haemolysis markers.
