Type-and-Screen Versus Type-and-Crossmatch
A type-and-screen determines ABO/Rh type and performs an antibody screen to identify clinically significant red cell alloantibodies prior to possible transfusion. [1] A type-and-crossmatch includes the same testing as a type-and-screen plus compatibility testing with donor red blood cells so that specific units can be selected and prepared for transfusion. [3]
Components of Type-and-Screen
- ABO and Rh(D) typing are performed on the patient specimen. [1]
- An antibody screen is performed to detect unexpected red cell antibodies in the patient’s serum or plasma. [1]
- If the antibody screen is negative, units can often be selected more rapidly when transfusion is required. [1]
Components of Type-and-Crossmatch
- ABO and Rh(D) typing are performed on the patient specimen. [3]
- An antibody screen is performed and any identified antibodies are used to guide selection of compatible donor units. [3]
- A crossmatch compatibility test is performed between the patient sample and donor red blood cell units so that specific units are considered compatible and can be readied for immediate release. [3]
Practical Operational Difference
- Type-and-screen is primarily designed to support timely availability of blood if transfusion becomes necessary, without initially crossmatching specific donor units. [3]
- Type-and-crossmatch requires compatibility testing with donor units, which supports issuing preselected, unit-specific red blood cells when transfusion is needed. [3]
Compatibility Testing Meaning
- Crossmatch refers to tests that combine recipient blood components with donor blood components to determine compatibility before transfusion. [4]
- In urgent or special settings, definitions can overlap with “electronic crossmatch” pathways when eligibility criteria are met after negative antibody screening, but these still rely on compatibility determination before issuing units. [2][4]
When Crossmatch Is More Commonly Ordered
- Type-and-crossmatch is ordered when compatibility with specific donor units is required rather than relying on a negative antibody screen alone. [3]
- Patients with positive antibody screening or significant transfusion/transplant history generally require more extensive compatibility assessment for unit selection. [2][3]
Key Safety Focus
- Both approaches rely on detection of red cell antibodies and correct ABO/Rh determination to reduce the risk of transfusion of incompatible red blood cells. [1][2]
- Crossmatch adds unit-specific compatibility testing, which is used to support release of specific donor units for transfusion. [3][4]