13.1 Scope - Patient testing (red cell immunohaematology)

These specifications provide guidance on the tests required for investigations performed on patient samples in red cell immunohaematology (RCI) laboratories in UK Blood Transfusion Centres. These include pre-transfusion and compatibility testing, tests associated with supporting the prevention and treatment of haemolytic disease of the fetus and newborn (HDFN), assessment of fetomaternal haemorrhage (FMH), and titration studies supporting ABO-mismatched transplant.

Extended testing of blood donors other than in the above contexts is covered in chapter 12.

It is assumed that RCI laboratories comply with the following guidelines from the British Society for Haematology (BSH):

• Guideline for blood grouping and red cell antibody testing in pregnancy [BSH, 2016]
• Guidelines for the specification, implementation and management of information technology systems in hospital transfusion laboratories [BSH, 2014]
• Guidelines for pre-transfusion compatibility procedures in blood transfusion laboratories [BSH, 2017]
• The Estimation of Fetomaternal Haemorrhage [BSH, 2009]

And also comply with:

• UKAS Medical Laboratories Accreditation – ISO15189
• Blood Safety and Quality Regulations 2005

Participation in relevant National External Quality Assessment Service Blood Transfusion Laboratory Practice (NEQAS BTLP) schemes is recommended. Exercise results should be reviewed and any findings acted upon.

This chapter is intended to cover practice in areas not included in published UK guidelines at the time of writing. Where practice differs either from published guidance or this chapter, laboratory managers should formally document the reasons for doing so and assess the associated risk.

References

BSH (2009). The Estimation of Fetomaternal Haemorrhage. https://b-s-h.org.uk/guidelines/guidelines/the-estimation-of-fetomaternal-haemorrhage

BSH (2014). Guidelines for the specification, implementation and management of information technology systems in hospital transfusion laboratories. https://doi.org/10.1111/tme.12159

BSH (2016). Guideline for blood grouping and red cell antibody testing in pregnancy. https://doi.org/10.1111/tme.12299

BSH (2017). Guidelines for pre-transfusion compatibility procedures in blood transfusion laboratories. https://b-s-h.org.uk/guidelines/guidelines/guidelines-for-pre-transfusion-compatibility-procedures-in-blood-transfusion-laboratories