An abstract from the recent Australian Society of Blood Transfusion meeting suggests that most of the ABO incompatibilities missed by the "immediate spin" (1.8% in their hands) were resolved by using washed RBCs from the segment in the immediate spin test (Hudson P et al, Transfus Med 2003; 13:106 - pdf file).

A colleague at a blood center in Southern California states that he has not seen this addressed in the US, and wonders if colleagues in the e-network forum have any comments.

The following responses have been received.

ADDENDA June 3, 2003

1. A blood bank medical technologist in Des Moines, Iowa reports that he has crossmatched about 40,000 units during his 30-year career, and so far he has have never seen an immediate spin test that failed to detect an ABO incompatibility. He estimates that he has seen no more than 20 such incompatible crossmatches and in most instances the incompatibility alerted the laboratory that a group A donor unit was inadvertently selected for a group O patient. He reports that he has used both washed and unwashed saline-suspended donor cells over the years.

Webmaster's note: Those in the field should be aware that while the immediate spin crossmatch is a good test for detecting ABO-incompatible donor selections, it is not foolproof. For more details please see the following articles:

• Judd WJ et al. Transfusion, 1988
• Shulman IA et al. Transfusion, 1991

Please submit comments to the e-Network Forum.

Ira A. Shulman, MD
CBBS e-Network Forum Editor & Moderator