Root cause analysis (RCA) of incompatible cross match at a tertiary care teaching hospital
Journal Title: Pathology And Laboratory Medicine - Year 2018, Vol 9, Issue 2
Abstract
Background : Blood transfusion is an essential part of therapy for many patients. Although life-saving for many patients, blood transfusion is not without risk. The main goal in transfusion medicine is that transfused blood should be compatible with the patient. The clinical and serologic evaluation, which allows for the transfusion of the most compatible (or "least incompatible") blood,requires a joint effort between the clinician and the transfusion medicine physician.[1] Aims : Root cause analysis of incidence & causes of incompatible cross matches in patients by column agglutination method Methods : In this prospective study, total of 349497cross matches were performed over period of last 4 & half years,out of which 867units were found incompatible by column agglutination method-CAT in polyspecific(Anti- IgG+ C3d)gel media.A root cause analysis protocol was formulated to resolve incompatibility to ensure safe transfusion. Results : On the evaluation of 349497crossmatches,only867units were found to be incompatible(0.14%).The major cause for incompatibility found in patients was AIHA-(32.87%).Other causes of incompatibility were infections(27.44%),multiple transfusions(17.41%),trauma(11.23%),Evan's syndrome(4.15%),Rh Negative mother(3.57%), SCA(2.99%)&incompatibility due to DAT positive Packed Red Cells(0.34%).The most common antibody found were anti-'c',anti-'s' & anti-'M'.The RCA protocol involves a thorough evaluation of the patient's clinical condition and underlying pathology to identify the cause.A logical stepwise approach will enable provision of safe transfusion to the patient.
Authors and Affiliations
Heena Pagi, Nidhi Bhatnagar, M D Gajjar, Tarak Patel, Mamta Shah, Shital Shah, Sangita Shah
Keywords
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