Red cell transfusion trigger-avoiding the highs and the lows

<正>One of the most vexing problems in AIHA is handling the acute situation where all blood is incompatible and the patient has severe,worsening anemia. Since the panagglutinin in the patient's serum typically reacts with all donor red cells,crossmatching donor blood is a difficult and time consuming process and probably of little benefit. The most pressing problem in a patient with previous pregnancies or transfusions is detecting alloantibody which may be hidden by the autoantibody. Sophisticated immunohematology laboratories can use a combination of procedures including differential adsorption and warm autoadsorption to identify underlying alloantibodies.