Objective: Type and crossmatch (TC) policy is the most common approach for pretransfusion compatibility testing prior to issue of blood for transfusion. As it involves
reserving of the blood units (usually up to 72 hours) prior to issue or un-reserving, it can lead
to excessive blood cross matching, inventory management problems, undue workload,
blood outdating and reagent wastage. Type and screen (TS) policy is an alternative
approach without the need to cross match and reserve blood units prior to issue. The aim
of the current study was to retrospectively assess the impact of the implementation of TS
policy for pre-transfusion compatibility testing on blood transfusion services at an urban
level Ι trauma center.
Methods: The study was done in two phases in the Department of Transfusion Medicine
at Jai Prakash Narayan Apex Trauma Center AIIMS, New Delhi, India. Transfusion data was
collected and compared during two phases: initial phase (Oct 2016-Mar 2017) of TC policy
and second phase (Apr 2017-Sept 2017) of TS policy.
Results: TS policy resulted in the reduction of C:T ratio from 5.3 to 1.9. Transfusion
probability increased to 29.5% during TS policy from 23.6% during TC policy. Issuable stock
index (ISI) also showed reduction from 12.5 to 11.4 after TS policy. Wastage as percentage
of issue (WAPI) was reduced from 2.3% (TC) to 1.3% (TS). TS policy also led to reduction
in expenses incurred on pre-transfusion compatibility testing by 35%. No hemolytic
transfusion reaction was reported during the study.
Conclusion: TS policy was found to be a safe and an efficient alternative approach to TC
policy for pre-transfusion compatibility at our center. We recommend the implementation
of TS policy, but each center should first assess its feasibility based on patient population,
blood bank resources and staff knowledge