(P-TS-92) Retesting Of Donor Non-ABO/D Red Cell Antigens: Is It Time To Rethink?

Background/Case Studies: In NJ, there were no reported errors due to antigen mistyping in 2015-2017. Nationwide, there were no errors due to antigen mistyping reported in 2017-2021. In the US, AABB standards, in accordance with FDA/CFR, do not require secondary testing by the transfusion service of Red Cell Antigens other than ABO and in some cases, RhD. Some facilities choose to do secondary testing, however.

Study

Design/Methods: Study Design: The purpose of this study was to ascertain via Google form:
1. Whether transfusion services in an 11- hospital health system in NJ are retesting non-ABO/RhD antigens previously tested by the blood supplier, and
2. Whether sites are willing to forego retesting moving forward.

Results/Findings: Result findings:
1. Approximately 71% of surveyed sites are currently retesting all previously tested and labeled antigen negative units from blood suppliers.
2. Approximately 80% of surveyed sites are already, (or agreed to) forego testing with approval of site medical directors.

Conclusions: Currently, no sites are retesting units tested initially tested onsite by transfusion service personnel. After investigation, retesting of previously tested stemmed from a historical antigen testing or labeling error from a blood supplier no longer in business. Since that error (approximately 15 years ago), there have been no other identified antigen testing or labeling issues (near miss or actual events) reported to regulatory authorities.
Rare antisera reagents can be expensive. In addition, testing can be time consuming and laboratory staffing may be limited. Further, the performance of full (AHG) crossmatching may identify an incompatibility when the antibody is currently demonstrating. Finally, elimination of unnecessary retesting may be beneficial for patient testing workload, with additional cost savings to the organization.