Principle:

Immediate-spin crossmatch ISXM is an abbreviated compatibility testing that detects most ABO incompatibility.  AABB Standards restricts its use to specific situations as indicated in the Policy section below.

Policy:

1. Applicability:
   1. ISXM may only be used when ALL of the following conditions are met:
      1. Negative antibody screen
      1. No history of antibodies
      1. No ABO/D antigen typing discrepancies
      1. Less than two (2) ABO/D determinations are on-file.
   2. Use the computer/electronic crossmatch whenever its specific criteria are met.
2. Testing:
   1. ISXM consists of reacting an RBC suspension with patient/serum or plasma, centrifuging, and immediately reading for agglutination or hemolysis.  THERE IS NO INCUBATION STEP, NO USE OF ANTIHUMAN GLOBULIN AHG REAGENT.
   2. If any hemolysis or agglutination is detected, the crossmatch is incompatible:
      1. Repeat the ISXM.
      2. Repeat the patient ABO/D AND unit ABO/D typings.
      3. Repeat the antibody screen.
      4. Perform full AHG crossmatch AND AHG/enzyme antibody panels.
      5. Refer the case to senior technical staff or a Transfusion Medicine consultant for further instructions.
         1. Case review will be documented in Medinfo HIIG computer system.
      6. DO NOT RELEASE THE RBCS UNTIL SO INSTRUCTED BY SENIOR STAFF.

References:

1. Technical Manual, Current Edition, AABB, Bethesda, MD, USA
2. Standards for Blood Banks and Transfusion Services, Current Edition, AABB, Bethesda, MD, USA
3. Guidelines to the Preparation, Use, and Quality Assurance of Blood Components, European Committee (Partial Agreement) on Blood Transfusion (CD-P-TS), Current Edition