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Discussion

Cross matching of blood

If both the donor and the recipient has the same blood type, does that mean that the donor blood is compatible with the recipient blood? Is cross-matching necessary in this case?

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Yes. There are a lot of different antigens in blood that go past ABO and Rh factors that can cause reactions.

Although in an emergency a cross and match goes out the window.

Yes cross matching is necessary. As our instructor said some blood may have more of a "strawberry " and another more of "raspberry" in it. And if patient had transfusions before harder it is to find a perfect match

absolutely. There is a lot more to matching than just blood type.

The A, B, O +/- blood types are just the major more lethal blood types, there are +400 some different antigens/antibodies that they screen for. For example big E, Kell, Little s etc.

Keep in mind also that not all blood products are matched in the same way. Packed RBCs tend to host antigens, platelets tend to host more antibodies. You can give a person who is blood type A platelets that are blood type B because the antigens for A/B are hosted on the red blood cell but the platelets could be carrying anti B antibodies and give them a reaction.

Every single exposure the patient has to a human blood product that carries antibodies/antigens can cause the patient to change their own antibodies/antigens so it is important to check.

Just wait until you have a patient switch from A to B to A again.

Throw in irradiation and things change even more.

The A, B, O +/- blood types are just the major more lethal blood types, there are +400 some different antigens/antibodies that they screen for. For example big E, Kell, Little s etc.

Keep in mind also that not all blood products are matched in the same way. Packed RBCs tend to host antigens, platelets tend to host more antibodies. You can give a person who is blood type A platelets that are blood type B because the antigens for A/B are hosted on the red blood cell but the platelets could be carrying anti B antibodies and give them a reaction.

Every single exposure the patient has to a human blood product that carries antibodies/antigens can cause the patient to change their own antibodies/antigens so it is important to check.

Just wait until you have a patient switch from A to B to A again.

Throw in irradiation and things change even more.

I wish we would have been given more of this type information as part of our science background for nursing. Some basic fact astounds me almost every week. I keep asking myself- " did I ever learn that but forgot?, or am I the only one that thinks it would be improtant to know that...?" We could have skipped the vast amount of time we spent in Chem 101- I have yet to have had to ballance a redox reaction or calculate Avagodro's number before I hung a unit of blood. I can't help but think if we dumped a few "Nursing Diagnoses" we would have time to teach nurses the difference between a hemolytic reaction and a leukocytic reaction to a blood product.

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