Is it time to switch from Coombs to Type and Screen crossmatching?

| Posted in: Science

Journal name: The Malaysian Journal of Medical Sciences
Original article title: Is It Time to Switch from Conventional Coombs Crossmatching to the Type and Screen Protocol?
The Malaysian Journal of Medical Sciences (MJMS) is a peer-reviewed, open-access journal published online at least six times a year. It covers all aspects of medical sciences and prioritizes high-quality research.
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Original source:

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Author:

Nithya M Baiju, Aboobacker Mohamed Rafi, Nittin Henry, Ramesh Bhaskaran, Susheela Jacob Innah, Athira Sasidharan


The Malaysian Journal of Medical Sciences:

(A peer-reviewed, open-access journal)

Full text available for: Is It Time to Switch from Conventional Coombs Crossmatching to the Type and Screen Protocol?

Year: 2023 | Doi: 10.21315/mjms2023.30.2.11

Copyright (license): CC BY 4.0


Download the PDF file of the original publication


Summary of article contents:

Introduction

Pre-transfusion testing is essential for ensuring that the blood transfused to patients is safe and compatible. This procedure commonly includes ABO grouping, Rh typing, antibody screening, and crossmatching. The Type and Screen (T&S) protocol, adopted in many developed countries, emphasizes the safe transfusion of red blood cells by reducing the need for traditional crossmatching. This observational study aimed to compare the safety, costs, and turnaround times (TAT) of the T&S protocol against conventional pre-transfusion testing methods among 1,800 patients scheduled for elective obstetrical and gynecological surgeries at a medical institution in Kerala, India.

Safety and Efficiency of T&S Protocol

The study found that the T&S protocol demonstrated a 100% safety level, successfully identifying unexpected antibodies in 0.4% of tested cases, indicating its effectiveness compared to traditional crossmatching. Notably, the T&S protocol did not significantly differ in cost from conventional methods, but it markedly reduced the turnaround time, averaging 23.8 minutes compared to 33 minutes for crossmatching. Furthermore, the T&S protocol allowed for a saving of about 30% of the technologists' time. This suggests that transitioning to the T&S method can enhance efficiency in blood transfusion practices without compromising patient safety.

Conclusion

In conclusion, the implementation of the T&S protocol for pre-transfusion testing is both safe and efficient, making it a superior alternative to traditional crossmatching protocols. The study underscored the benefits of T&S, including a significant reduction in turnaround time and the timely identification of unexpected antibodies, which would otherwise go undetected. As hospitals strive to optimize blood transfusion practices, adopting the T&S protocol can lead to improved patient outcomes and better inventory management in blood banks, confirming its utility in modern transfusion medicine.

FAQ section (important questions/answers):

What is the Type and Screen (T&S) protocol in blood transfusion?

The T&S protocol is a pre-transfusion testing method that includes ABO and Rh typing, along with the detection of unexpected antibodies. It is designed to ensure patient safety by maximizing the availability of compatible blood while reducing unnecessary crossmatching.

How does the safety of T&S compare to Coombs crossmatching?

The T&S protocol demonstrated a 100% safety level in the study, detecting unexpected antibodies in 0.4% of cases. This indicates that T&S is equally safe as Coombs crossmatching while being more efficient in blood transfusion practices.

What were the findings regarding costs and turnaround times?

The study found no significant cost differences between T&S and Coombs crossmatching. However, T&S had a quicker turnaround time, averaging 23.8 minutes compared to 33 minutes for Coombs crossmatching, saving about 30% of laboratory time.

Why is the T&S protocol preferred in modern transfusion practices?

The T&S protocol is preferred because it efficiently manages blood inventory, quickly identifies compatible blood, and improves hospital transfusion practices without compromising patient safety. It allows hospitals to issue more blood units on demand, enhancing overall care.

Glossary definitions and references:

Scientific and Ayurvedic Glossary list for “Is it time to switch from Coombs to Type and Screen crossmatching?”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.

1) Blood:
Blood is a vital fluid circulating in the human body, responsible for transporting oxygen, nutrients, and waste products. In medical studies, especially transfusion medicine, blood group compatibility is crucial for safe transfusions. This study investigates transfusion practices, emphasizing blood types and the protocols for testing compatibility, such as ABO grouping and Rh typing.

2) Table:
In the context of this study, 'table' likely refers to the organized presentation of data that summarizes findings. Tables are essential for conveying complex information succinctly, allowing readers to compare safety protocols like Type and Screen versus traditional crossmatching in transfusion practices. They help highlight differences in outcomes, costs, and turnaround times.

3) Study (Studying):
A study refers to a systematic investigation aimed at understanding specific phenomena. In this context, it involves the comparison of transfusion testing protocols. Rigorous methodologies, like observational studies, help in assessing safety, efficiency, and cost-effectiveness of the Type and Screen protocol against traditional methods, contributing to evidence-based medical practices.

4) Indian:
The term 'Indian' denotes a connection to India or its people. In this context, it emphasizes the setting of the study, capturing local practices, genetic factors, cultural aspects, and healthcare outcomes that may differ from other populations. Understanding regional dynamics is crucial for improving transfusion protocols tailored to the Indian demographic.

5) India:
India, a country in South Asia, has a diverse population and unique healthcare challenges. The relevance of the study lies in its focus on transfusion practices within the Indian context, where specific regional practices regarding blood donation, safety protocols, and healthcare access necessitate tailored approaches to improve patient outcomes in obstetrics and gynecology.

6) Rules:
Rules refer to the guidelines or protocols established for safe practices in healthcare, especially concerning blood transfusions. In this study, adherence to transfusion guidelines—such as those recommended by blood banks—affects patient safety and the efficiency of procedures. Understanding and refining these rules is vital for improving transfusion outcomes.

7) Kerala:
Kerala is a state in southern India known for its high literacy rates and advanced healthcare systems. The study's location in Kerala underscores its relevance in analyzing transfusion practices specific to this region, reflecting unique demographic and healthcare characteristics. Regional insights enhance the understanding of transfusion safety and protocol effectiveness.

8) Thalassemia:
Thalassemia is a genetic blood disorder characterized by the reduced production of hemoglobin. This condition often requires regular blood transfusions, making compatible blood supply crucial. The relevance of studying transfusion protocols in relation to thalassemia patients emphasizes the impact of the Type and Screen method on managing the needs of such vulnerable populations.

9) Attending:
In a healthcare context, 'attending' often refers to healthcare professionals who are responsible for the direct care of patients. This term is relevant in the study as it involves healthcare providers overseeing transfusion practices and ensuring compliance with testing protocols. Their involvement directly impacts patient safety and care quality.

10) Medicine:
Medicine encompasses the science and practice of diagnosing, treating, and preventing illnesses. The study's focus on transfusion medicine highlights its importance in ensuring safe blood transfusion practices. Understanding translational medicine translates research findings into healthcare practice, thereby improving patient care outcomes in transfusion protocols.

11) Gupta:
Gupta is likely a reference to a researcher or contributor involved in the study's design, analysis, or findings. Naming key authors and their contributions underscores the collaborative nature of medical research, emphasizing the importance of diverse expertise in enhancing transfusion protocols and improving patient safety outcomes.

12) Delhi:
Delhi, the capital city of India, serves as a significant backdrop for healthcare studies. Its diverse population and healthcare infrastructure present unique challenges and opportunities regarding transfusion practices. Analyzing transfusion safety in such an urban setting can yield insights applicable to similar populations in India and elsewhere.

13) Grove:
Grove may refer to a researcher or a publication relevant to transfusion medicine. Noting influential texts or authors provides context for understanding how current practices build upon previous research, emphasizing the continuity and evolution of medical knowledge in optimizing transfusion protocols based on comprehensive evidence.

14) Dara:
Dara might refer to a contributor or researcher in the field. Recognizing individuals involved in the study reinforces the relevance of collaboration in medicine. Their collective insights are essential in developing effective protocols, ensuring that transfusion practices are not only scientifically sound but also practically applicable within diverse healthcare systems.

15) Post:
Post in this context might refer to post-transfusion monitoring or procedures. This aspect is critical in transfusion medicine, as it involves assessing patient reactions and ensuring safety after blood transfusions. Understanding post-transfusion outcomes can help refine protocols and improve patient care through better monitoring strategies.

16) Drug:
Drugs often interact with various medical procedures, including blood transfusions. Understanding such interactions is crucial—some medications can complicate transfusion responses. The study may emphasize the importance of considering drug regimens when planning transfusions, ensuring comprehensive patient safety and optimal therapeutic outcomes.

17) New Delhi:
New Delhi, being the capital of India, represents a metropolitan area with diverse healthcare needs. Its significance in the study lies in understanding urban healthcare delivery systems and how these affect transfusion practices. Insights gathered from such environments can influence broader public health policies across India.

18) Discussion:
Discussion refers to the critical analysis of study findings. In scientific papers, this section interprets results, connects them with existing literature, and explores implications. It allows researchers to debate the relevance of findings, limitations of methods, and future directions for research in transfusion practices, thereby enhancing overall understanding.

19) Pregnant:
Pregnant refers to women who are expecting a child, a significant demographic in transfusion studies. Understanding the implications of blood transfusions during pregnancy can help address unique risks and optimize management protocols. This focus is essential for maternal and fetal safety during obstetric procedures that involve transfusions.

20) Rupee:
Rupee, the currency of India, contextualizes the economic aspects related to the costs of blood transfusion procedures. Analyzing costs aids healthcare administrators in budget planning and resource allocation. The study's cost analysis emphasizes the financial implications of different transfusion protocols in healthcare settings.

21) Food:
Food is a basic necessity and indirectly relates to overall health, impacting factors like nutritional status and blood donor suitability. While it may not be the primary focus of the study, understanding dietary habits can inform blood donation awareness and influence transfusion practices among diverse populations.

22) Siju:
Siju could refer to a key contributor involved in the study, highlighting the collaborative nature of medical research. Recognizing individuals like Siju points to the importance of various roles in conducting thorough research, emphasizing how multidisciplinary teams contribute to enhancing transfusion protocols and patient safety.

Other Science Concepts:

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Discover the significance of concepts within the article: ‘Is it time to switch from Coombs to Type and Screen crossmatching?’. Further sources in the context of Science might help you critically compare this page with similair documents:

Blood transfusion, Statistical analysis, Indian population, Significant difference, Standard operating procedure, General population, Observational study, Clinical relevance, Institutional ethics committee, Surgical Procedure, Patient safety, Tertiary care hospital, Independent t-test, Tertiary care centre, Red Blood Cell, Positive predictive value, Negative predictive value, Blood cell, Cost Comparison, Compatibility testing, Crossmatching, Department of Obstetrics and Gynaecology, Emergency use, Turnaround time, Inventory management, Safety parameter, Indian patients.

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