Analysis on causes of secondary incompatibility of crossmatching with microcolumn gel method and strategies for blood transfusion
Yue Yinping
Han Wei
Abstract：Objective To analyze the causes of secondary incompatibility of cross matching with microcolumn gel method and explore the corresponding blood transfusion countermeasures.Methods A cohort of 184 patients exhibiting minor side incompatibility in cross-matching via the microcolumn gel technique,admitted to Xuzhou Mining Group General Hospital in January to December,2023,were selected as the study cohort.Cross-matching results were systematically analyzed,with subsequent transfusions of washed red blood cells(RBC)and suspended leukocyte-reduced RBC respectively administered.Results Among the 184 cases of secondary incompatibility,165 cases(accounting for 89.7%)showed positive results of direct antiglobulin test(DAT),2 cases(accounting for 1.1%)exhibited irregular antibodies in donors,9 cases(accounting for 4.9%)demonstrated in vitro specimen sensitization,5 cases(accounting for 2.7%)were false positive results,and 3 cases(accounting for 1.6%)suggested potential low-frequency antigen-antibody reactions.Among DAT-positive patients,the proportion of suspended leukocyte-reduced RBC transfusions was significantly higher than that of washed RBC transfusion across all disease categories(hematologic diseases:64.0%vs.36.0%;malignancies:80.0%vs.20.0%;nephropathy:78.6%vs.21.4%;severe infections:62.5%vs.37.5%;drug-induced cases:73.9%vs.21.6%;all P<0.05).No statistically significant differences were observed in adverse reaction rates or transfusion efficacy between washed RBC and suspended leukocyte-reduced RBC transfusion in DAT-positive patients(adverse reactions:1.96%vs.1.75%;efficacy rates:94.12%vs.93.86%;both P>0.05).Conclusions DAT positivity is the primary cause of secondary incompatibility in cross matching.Supplemental testing with the polybrene method is recommended to exclude false positive results.Tailored selection of RBC preparations based on clinical context provides patients with scientific,rational and safe transfusion strategies.
Keywords：Microcolumn gel methodCross matchingSecondary incompatibilityDirect antiglobulin testWashed red blood cellSuspended leukocyte-reduced red blood cell
Publication Date：2025-03-30
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：3( 63-65 )