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World Blood Donor Day 2019: Blood Typing And Crossmatching
Blood donation or blood transplantation is not just carried out on whimsy but involves certain steps and methods which will help the doctor understand the compatibility between the donor and the donee. Blood typing and crossmatching help the doctor in learning if your blood is compatible with donor blood or organs [1] .
What Is Blood Typing?
This process helps in understanding the type of blood you have. An essential step required in blood transfusion and blood donation, blood typing is critical because it is important to know your blood group and receiving blood that is not compatible to your blood type can cause a dangerous immune response, studies reveal [2] .
There are four main types of blood groups [3] :
- type A, which contains type-A antigens
- type B, which contains type-B antigens
- type AB, which contains type-A and type-B antigens
- type O, which contains neither type-A nor type-B antigens
The type of your blood is determined by the presence of certain antigens on your red blood cells. These antigens trigger the production of antibodies by your immune system [4] . Apart from these four above-mentioned blood groups, your blood group can be classified as Rh positive (+) or Rh negative (-). This will be carried out on the basis of the presence or absence of a particular protein on your RBCs (rhesus factor) [4] .
What Is Crossmatching?
This test helps in understanding whether there will be any harmful interaction between your blood and the specific donor blood or organs. Crossmatching helps the doctor in understanding as well as predicting the way your body will be reacting to the donor blood. The process helps in understanding whether the specific donor blood or organs are compatible with your own [5] .
Crossmatching is necessary because, apart from the anti-B and anti-A antibodies, there are possibilities of other types of antibodies being present in your body and can negatively interact with the donor blood [6] .
Uses Of Blood Typing & Crossmatching
Carried out for understanding if the donor blood types are compatible with your blood, crossmatching and blood typing help prevent the onset of harmful interactions. You will be required to be crossmatching or blood typing, or both in the event of the following [7] :
- if you are scheduled to receive a blood transfusion or organ transplant,
- if you have certain medical conditions, such as severe anaemia or a bleeding disorder, and
- if you are scheduled to undergo a medical procedure with the risk of significant blood loss.
Blood typing is also advised when you are pregnant because, if the foetus has a different blood type than you, it raises their risk of developing a type of anaemia called hemolytic disease [8] .
As mentioned before, carrying out blood typing help the doctor understands the compatibility between the donor and the donee [9] . That is,
- If you have type A blood, you should only receive type A or O blood.
- If you have type B blood, you should only receive type B or O blood.
- If you have type AB blood, you can receive types A, B, AB, or O blood.
- If you have type O blood, you should only receive type O blood.
- If you have type AB blood, you're known as a universal recipient and can receive any category of donor blood.
- If you have type O blood, you're known as a universal donor, as anyone can receive type O blood.
Performing Blood Typing & Crossmatching
The procedure will begin with the doctor collecting a sample of your blood to be sent to a laboratory for testing. The steps involved are [10] :
- Collecting the sample.
- Blood typing the sample, where the technician will conduct several tests to type your blood. Your blood will be mixed with anti-A and anti-B antibodies. If the blood cells agglutinate (clump together), your blood has reacted with one of the antibodies and is called as forward typing. Then a reverse typing will be conducted, followed by an Rh typing.
- Crossmatching the sample, where your blood sample will be mixed with a sample of the donor material; and check for reactions.
Once the result is produced, your blood type will be classified as type A, B, AB, or O; as well as Rh+ or Rh-. And the crossmatching will help the doctor analyse the safety of receiving the fitting blood type.
In the case of commercial antibodies, if your blood cells clump when mixed with anti-A antibodies, you have type A blood, with anti-B antibodies, you have type B blood and with both anti-A and anti-B antibodies, you have type AB blood.
In back-typing, if your blood cells clumps when mixed with type B cells, you have type A blood, with type A cells, you have type B blood and with type A and B cells, you have type O blood.
In Rh typing, if your blood cells clump when mixed with anti-Rh antibodies, you have Rh+ blood. If they don't clump, you have Rh- blood [11] .
In crossmatching, if your blood cells clump when mixed with a donor sample, the donor blood or organ is incompatible with your blood [12] .
- [1] Kessler, R. J., Reese, J., Chang, D., Seth, M., Hale, A. S., & Giger, U. (2010). Dog erythrocyte antigens 1.1, 1.2, 3, 4, 7, and Dal blood typing and cross‐matching by gel column technique.Veterinary clinical pathology,39(3), 306-316.
- [2] Battrell, C. F., Wierzbicki, D., Clemmens, J., Capodanno, J., Williford, J. R., Elmufdi, C., & Sprague, I. (2012).U.S. Patent No. 8,318,439. Washington, DC: U.S. Patent and Trademark Office.
- [3] Rouault, C., & Gruenhagen, J. (1978). Reorganization of blood ordering practices.Transfusion,18(4), 448-453.
- [4] Oostendorp, M., Lammerts Van Bueren, J. J., Doshi, P., Khan, I., Ahmadi, T., Parren, P. W., ... & De Vooght, K. M. (2015). When blood transfusion medicine becomes complicated due to interference by monoclonal antibody therapy.Transfusion,55(6pt2), 1555-1562.
- [5] Gunpinar, S., & Centeno, G. (2015). Stochastic integer programming models for reducing wastages and shortages of blood products at hospitals.Computers & Operations Research,54, 129-141.
- [6] Battrell, C. F., Wierzbicki, D., Clemmens, J., Capodanno, J., Williford, J. R., Elmufdi, C., & Sprague, I. (2015).U.S. Patent No. 9,146,246. Washington, DC: U.S. Patent and Trademark Office.
- [7] Lee, Q. J., Mak, W. P., Yeung, S. T., Wong, Y. C., & Wai, Y. L. (2015). Blood management protocol for total knee arthroplasty to reduce blood wastage and unnecessary transfusion.Journal of Orthopaedic Surgery,23(1), 66-70.
- [8] Brand, A. (2016). Immunological complications of blood transfusions.La Presse Médicale,45(7-8), e313-e324.
- [9] Blumberg, N., & Bove, J. R. (1978). Un-cross-matched blood for emergency transfusion: one year's experience in a civilian setting.Jama,240(19), 2057-2059.
- [10] Palmer, T., Wahr, J. A., O’reilly, M., & Greenfield, M. L. V. (2003). Reducing unnecessary cross-matching: a patient-specific blood ordering system is more accurate in predicting who will receive a blood transfusion than the maximum blood ordering system.Anesthesia & Analgesia,96(2), 369-375.
- [11] Swarup, D., Dhot, P. S., Kotwal, J., & Verma, A. K. (2008). Comparative study of blood cross matching using conventional tube and gel method.Medical Journal Armed Forces India,64(2), 129-130.
- [12] Henderson, C. A., McLiesh, H., Then, W. L., & Garnier, G. (2018). Activity and longevity of antibody in paper-based blood typing diagnostics.Frontiers in chemistry,6.
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