What is Crossmatching?

-The Crossmatch also known as compatibility testing,  pretransfusion testing or type and crossmatch

(Type and Cross; T & C).  The definition of a compatibility test (crossmatch) is a series of procedures use
to give an indication of blood group compatibility between the donor and the recipient and to detect
irregular antibodies in the recipient's serum.

Crossmatching Procedure

 Identification of the recipient and recipient blood sample is crucial since the major of the hemolytic
transfusion reactions are due to errors in patient or sample identification.
 ABO and Rh typing of the recipient's blood and resolving any ABO discrepancies.  If the
discrepancy can not be resolved before the patient needs the transfusion type O blood should be
given. If problems arise with the D testing, Rh negative blood should be given.
 Performing an antibody screen on the recipient's serum for clinically significant antibodies.  These
antibodies are most likely to occur in the 37oC and AGT phases of testing.  Each negative AGT
test must be followed by "Coombs Control Check Cells." An autocontrol may or may not be used. 
Some labs prefer to perform this routinely during the antibody screen while others will only
include it if an antibody needs to be identified.  The autocontrol has to be part of the antibody
identification procedure.  The SOP of each institution must be followed by all individuals
performing these tests.
 Comparing present findings with previous records for the recipient.  If previous testing has been
performed on the recipient and should match current testing. These comparisons can give
assurance that no identification errors have occurred, but it is not proof.  Records would also
show if clinically significant antibodies have been detected in the past.  These antibodies may be
presently at undetectable levels.  Any history of clinically significant antibodies, even if 
undetectable now in the patient, dictates an antiglobulin phase crossmatch needs to be done
between the recipient's serum and the donor's cells.
 Confirmation of the ABO and Rh type of the red cell components being given when the shipment
of blood is received in the laboratory.
 Selection of appropriate ABO and Rh component units for the recipient first would be the same
ABO and Rh type.  Transfused donor red cells must be ABO compatible with the patient's plasma
and whatever antibodies may be present.  Transfused plasma must be ABO compatible with the
recipient's red cells. 
MAJOR AND MINOR CROSSMATCH
Major crossmatch- testint the patient’s serum with donor cells to determine whether the patient has an antibody
which may cause hemolytic transfusion reaction or decreased survival of donor.

Minor crossmatch involves testing the patient cells with donor plasma to determine whether an antibody in the
donor’s plasma directed against an antigen on the patient cells.