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Pathology and Laboratory Medicine
Transfusion Essentials

​Crossmatch Incompatible Red Blood Cells

  • ​Crossmatch incompatible red blood cells (RBCs) are ABO compatible, but found to be incompatible with donor red blood cells due to non-ABO auto-antibodies.
  • Crossmatch incompatible RBCs are issued for transfusion if testing protocols have been exhausted and fully compatible red blood cell units cannot be found.
  • Release of RBC from the Transfusion Medicine Laboratory identified as crossmatch incompatible will have been authorized by the Transfusion Medicine Physician on-call.
  • A neon green sticker on the chart copy of the transfusion slip will read: “Incompatible RBCs. Monitor for hemolysis. Refer to Lab Services Manual (Transfusion Essentials)”.
  • The patient must be monitored throughout and following the transfusion by staff who are “hypervigilant for acute intravascular hemolytic reaction[i]”, although such reactions are rare. 

1 Weinstein, R. 2012 Clinical Practice Guide on Red Blood Cell Transfusion. Adapted from ‘Red Blood Cell Transfusion: A Clinical Practice Guideline from the AABB’ Ann Intern Med 2012; 158; 49-58.)

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Laboratory Controlled Document LSM-792 v3

Last Modified: Monday, March 16, 2020 |
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