EFFECTS AND PROBLEMS OF TYPE AND SCREEN ON THE EFFICIENT USAGE OF SURGICAL BLOOD

• Published in: Journal of the Japan Society of Blood Transfusion Vol. 36; no. 3; pp. 448 - 451
• Main Authors: Oguro, Hiroyuki, Tsuji, Hajime, Sasada, Yuji, Nishimura, Hiroshi, Uno, Masashi, Nakagawa, Masao
• Format: Journal Article
• Language: Japanese
• Published: The Japan Society of Transfusion Medicine and Cell Therapy 1990
• ISSN: 0546-1448; 1883-8383
• DOI: 10.3925/jjtc1958.36.448

Excessive preoperative crossmatching results in the increased outdating units of blood. We have adopted the Type and Screen (T & S) system and Maximum Surgical Blood Order Schedule (MSBOS) in elective surgical procedures in order to reduce the excessive crossmatching and to use the limited blood resourcces more efficiently. The following guidelines were applied to the operative procedures: (1) T & S, which consists of an ABO-Rh typing and screen for unexpected antibodies, was recommended for those procedures with less than 400ml of predicted operative hemorrhage. If unexpected antibodies or some clinical complications were discovered, pre-operative crossmatch was performed following the next criteria. (2) For all other procedures mentioned above, units which did not exceed 1.5 times the average volume of operative hemorrhage were crossmatched for the patients. If additional units were required during the surgical procedure, they were issued within about 15 minutes after immediate spin in saline solution. Then we proceeded to complete our standard crossmatch in three phases (bromelin, albumin and antiglobulin). Within the first one year of the introduction of T & S and MSBOS, C/T ratio decreased from 3.9 to 2.8, and the total number of crossmatches decreased by 14.5%. Even when blood was required urgently in a surgical procedure, blood could be issued quickly and transfused safely. From these results, the introduction of the T & S system and MSBOS in our hospital was proved to be effective in the efficient usage of surgical blood. Also some problems, found in the process, are discussed in this paper.