Anu Thomas/LinkedIn
Oct 18, 2026, 07:55
Anu Thomas: A Stepwise Laboratory Approach to Positive IAT and Pretransfusion Compatibility
Anu Thomas, Assistant Professor at Government Medical College, Kozhikode, shared a post on LinkedIn:
“Positive Indirect Coombs Test (IAT): How to Find Compatible Blood?
A positive IAT does not necessarily mean that compatible blood cannot be issued.
The key is to identify the antibody and select appropriate donor units.
A stepwise approach:
- Verify patient identity, transfusion history and previous antibody records.
- Perform antibody identification using an appropriate panel.
- Select ABO-compatible, antigen-negative red cell units for clinically significant alloantibodies.
- Perform an antiglobulin (IAT) crossmatch to confirm serological compatibility.
- If incompatibility persists, investigate additional alloantibodies, autoantibodies, low-frequency antigens and technical causes.
Important: In patients with warm autoantibodies, investigate underlying alloantibodies before selecting blood.
In life-threatening emergencies, do not delay urgently needed transfusion unnecessarily; follow the emergency-release protocol.
Identify the antibody.
Select the right units.
Ensure safe transfusion.”
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