Is the indirect antiglobulin crossmatch justified?

Pretransfusion testing has undergone a rationalization, resulting in a more efficient transfusion service but with no compromise to patient safety. Current debate centres on the necessity of performing an antiglobulin crossmatch if a suitable screening test for detecting red cell antibodies is negative. A retrospective study of all pretransfusion testing was undertaken to determine the specificities and possible clinical significance of antibodies detected by the crossmatch alone. The results indicate that omission of the crossmatch will not compromise patient safety. This will have benefits to both the patient and the laboratory. The patient will benefit because of less time needed to provide homologous donor blood. The laboratory will benefit from cost savings as a result of less antiglobulin reagent being used, less time taken for providing blood (and hence further cost savings) and less blood needing to be held in stock. The cost savings generated could be channelled into areas that will result in greater patient safety at a lower cost than crossmatching. Two of these areas are prevention of patient and specimen identification errors by the use of a unique transfusion number system and the full utilization of an autologous blood service.