2nd pre-transfusion sample for ABO group confirmation. Is it feasible? Proceedings from AMLS LABCON workshop on BCSH 2012 Guidelines John * Quigley , John Sheehy (Chair), John Crumlish, Fionnuala Ni Chonchubhair, Bernie Quirke, Suzanne Traynor, Fabian McGrath The Academy of Medical Laboratory Science (AMLS) Transfusion & Transplantation Science Advisory Body (TTSAB) INTRODUCTION The third edition of the BCSH guidelines for Pre-Transfusion Compatibility Procedures in Blood Transfusion Laboratories was released in October 20121. The new guideline is a comprehensive collaboration with 19 key recommendations, five relating to ABO typing and compatibility, six to the detection of atypical red cell antibodies while the remainder relate to processes within the blood transfusion laboratory. METHOD In April 2013, the Academy of Medical Laboratory Science (AMLS) Transfusion and Transplantation Science Advisory Body (TTSAB) organised a workshop at the AMLS conference in Kilkenny. The focus of the workshop was to identify a more co-ordinated approach to the implementation of the key recommendations of this new guideline. Prior to the workshop a circular was sent to 51 blood transfusion (BT) laboratories in the Republic of Ireland with a request for each laboratory to rank their top 3 recommendations that would have most local impact. 14/51 (27.5%) of BT Laboratories responded, representing the major transfusion centres. Attendees of the workshop were divided into 6 groups to discuss the recommendations. RESULTS BCSH Recommendation 12 received the most votes nationwide and unsurprisingly this key recommendation dominated the workshop. Recommendation 12 states: “Unless secure electronic patient identification systems are in place, a second sample should be requested for confirmation of the ABO group of a first time patient prior to transfusion, where this does not impede the delivery of urgent red cells or other components”. This recommendation is to address the incidence of wrong blood in tube (WBIT) which is estimated to be 1 in 2,000 samples2 and consequently reduce the risk of an ABO incompatible blood transfusion. CONCLUSIONS All participating groups believed that each laboratory should conduct their own risk assessment to determine the requirement to introduce this recommendation. Factors that were considered included: legal implications, over usage of group O red cells, impact of the additional workload on the laboratory and the impact to hospitals should the IBTS implement this requirement. Consideration of the blood transfusion laboratories to issue a “confirmatory group check tube” was welcomed by most. However, there was a general consensus amongst all participants that an ITbased solution was the key requirement to the implementation of this recommendation with the introduction of phase 2 and 3 of the Electronic Blood Tracking System (EBTS). 1 in 2000 2 WBIT 1 in 10 previous untested ~50% O ~50% non -O Risk.. 1/4 x 1/10 x 1/2,000 = 1/80,000 The risk of incompatible blood being selected is 1 in 80 000 3 REFERENCES 1. Milkins, C., Berryman, J., Cantwell, C., Elliott, C., Haggas, R., Jones, J., Rowley, M. & Williams, M. (2013) Guidelines for pretransfusion compatibility procedures in blood transfusion laboratories. Transfusion Medicine, 23, 3–35. 2. Dzik, W.H., Murphy, M.F., Andreu, G. et al. (2003) An international study of the performance of blood sample collection. Vox Sanguinis, 85, 40–47. 3. Wallis, J.P. (2013) Pre-transfusion compatability guidelines: a new edition. Transfusion Medicine, 23, 1–2. RESEARCH POSTER PRESENTATION DESIGN © 2012 www.PosterPresentations.com Reprints: [email protected]