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Group and Screen - Provincial

Discipline

Transfusion Medicine

Overview

Description

  • Pre-transfusion tests to determine the patient ABO group and Rh type, and check for non-ABO antibodies. Results must be available before crossmatched red blood cells can be issued.

Alias

  • Type and Screen.
  • Antibody screen.
  • T&S.
  • Compatibility testing.

Specimen Information

Specimen types accepted

  • Whole Blood

Specimen collection container

Required volume

  • Optimal volume: 8 mL (2 x 4 mL tubes)
  • Minimum volume: 4 mL
  • Pediatric volume: 1 mL

Submitting the minimum volume makes it impossible to repeat the test or perform confirmatory/reflex testing. In some situations, a minimum volume may require a second collection.

Transport and stability

  • Store at 2-8°C.
  • Must be tested within 96 hours of collection.

Rejection criteria

Testing Information

Relevant clinical history

  • Recent transfusion history (within the last 3 months).

  • Recent pregnancy (within the last 3 months). 

  • Prior hematopoietic progenitor stem cell transplant.

  • Previously identified antibodies (If patient presents with an Antibody Card, photocopy card and forward it along to Transfusion Medicine with the test request form).

Clinical interpretation

  • If there is any discrepancy of ABO group test results, crossmatched group O red blood cells will be issued until the discrepancy is resolved.
  • A positive antibody screen may necessitate further testing to inform optimal blood component or product transfusion decisions. Contact the Transfusion Medicine Physician if assistance is required.

Performance

Methodology

  • Gel testing, tube testing or solid phase testing

Days/times performed

  • Complex sites (RUH and RGH): testing available 24 hours/7 days a week. 

  • Advanced sites: testing available; hours variable. 

  • Basic sites: testing available; hours variable.

  • Current State Blood Drop Map

Maximum laboratory time

  • Routine:
    • Complex and Advanced sites: within 24 hours of receipt in Transfusion Medicine.
    • Basic sites: within 48 hours of receipt in Transfusion Medicine.
  • Urgent:
    • Within 4 hours of receipt in Transfusion Medicine.
  • STAT:
    • Within 1 hour of receipt in Transfusion Medicine.

Note: Delays in reporting may be encountered in the presence of unexpected antibodies.

Specimen retention time

  • 5 weeks

Other information

Reflex Testing
  • Reflex testing is determined by results of initial testing and patient clinical circumstances.
Additional Comments
  • Required every 96 hours.
    • This may be extended as per local policy during the current hospital admission if patient has not been transfused or pregnant in the last 3 months. Contact Transfusion Medicine for confirmation.
  • Neonate: Infants less than 4 months of age require a group and screen tested once during initial hospital admission. Contact Transfusion Medicine for confirmation.
  • Pre-admission Clinic testing may be valid up to 28 days provided that the patient has not been transfused or pregnant in the last 3 months. Contact Transfusion Medicine for confirmation.
  • Group specific red blood cells will be issued when:
    • a blood group result is completed on the current admission
    • AND
    • a second specimen is collected and tested (for blood group confirmation) or a historical blood group is available
  • Group O red cells will be issued until two patient ABO/Rh group results are available (from two separate specimens).
  • In expectant patients, routine Prenatal Group and Antibody Screen tests are performed by the Transfusion Medicine Laboratory in Saskatoon and Regina.
Forms Required
  • Facility specific Transfusion Medicine Lab Test Request Forms.
  • In the absence of a facility specific form or for referral of specimens to designated sites for testing, use the SASK BLOOD RBC CROSSMATCH/ANTIBODY INVESTIGATION REFERRAL REQUISITION.
    • Note: Saskatoon has NOT yet implemented the Transfusion Service Identification Number (TSIN) banding system in patients who require pre-transfusion testing, and as a result, any requests for a ‘TSIN’ on SaskBlood requisitions for specimens referred in to Saskatoon for testing may be left blank.
Relevant Recent Medication History
  • Planned or ongoing used of CD-38 monoclonal antibody therapy (i.e., Daratumumab, Isatuximab) in patients with multiple myeloma.

Last Updated: June 12, 2024