Incompatible crossmatch following nonreactive antibody detection test. Frequency and cause

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Abstract
To determine the frequency and cause of an incompatible crossmatch found in specimens for which the antibody detection test was nonreactive, 261,136 crossmatches performed on 116,278 patient samples from .apprx. 46,000 different patients were reviewed. Patients (101) were identified whose sera were incompatible in at least 1 crossmatch following a nonreactive antibody detection test. The cause of the incompatibility was determined in 69 of these. Incompatibility was detected only after 37.degree. C incubation and/or after the antiglobulin phase in 36 (52%). Incompatibility was detected after an immediate-spin and/or incubation at room temperatures in 33 (48%). Serologic evaluation did not identify the cause of the incompatibility in 16 of the 101 patients. In 8 of these 16 the incompatibility was noted only after 37.degree. C incubation and/or after the antiglobulin phase. Detailed serologic evaluation was not performed on 16 of the 101 patients (all of whose sera were incompatible with only 1 donor unit). In 12 of these 16, the incompatibility was detected only after the antiglobulin phase.