Blood type

A blood type (also called a blood group) is a classification of blood based on the presence or absence of inherited antigenic substances on the surface of red blood cells (RBCs). These antigens may be proteins, carbohydrates, glycoproteins, or glycolipids, depending on the blood group system. Some of these antigens are also present on the surface of other types of cells of various tissues. Several of these red blood cell surface antigens can stem from one allele (or an alternative version of a gene) and collectively form a blood group system. Blood types are inherited and represent contributions from both parents. A total of 35 human blood group systems are now recognized by the International Society of Blood Transfusion (ISBT). The two most important ones are ABO and the RhD antigen; they determine someone's blood type (A, B, AB and O, with +, − or Null denoting RhD status).

Many pregnant women carry a fetus with a blood type which is different from their own, which is not a problem. What can matter is whether the baby is RhD positive or negative. Mothers who are RhD- and carry a RhD+ baby can form antibodies against fetal RBCs. Sometimes these maternal antibodies are IgG, a small immunoglobulin, which can cross the placenta and cause hemolysis of fetal RBCs, which in turn can lead to hemolytic disease of the newborn called erythroblastosis fetalis, an illness of low fetal blood counts that ranges from mild to severe. Sometimes this is lethal for the fetus; in these cases it is called hydrops fetalis.

Cross-matching

Cross-matching (or crossmatching) blood, in transfusion medicine, refers to the test that is performed prior to a blood transfusion in order to determine if the donor's blood is compatible with the blood of an intended recipient. Cross-matching is also used to determine compatibility between a donor and recipient, in organ transplantation or blood transfusion. Compatibility is determined through matching of different blood group systems, the most important of which are the ABO and Rh system, and/or by directly testing for the presence of antibodies against a sample of donor tissues or blood.

Cross-matching is done by a certified laboratory technologist, in a laboratory. It can be done electronically, with a computer database if a patient has previously been tested, or serologically by way of testing. Simpler tests may be used to determine blood type (only), or to screen for antibodies (only). (indirect Coombs test).

Types of cross-matching

Abbreviated cross-matching

Immediate-spin cross-matching (ISCM)