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Saneha Anjum Shaikh: Why Antibody Screening Must Be Standard Practice in Modern Blood Banking

Saneha Anjum Shaikh/LinkedIn

Jul 23, 2026, 14:32

Saneha Anjum Shaikh: Why Antibody Screening Must Be Standard Practice in Modern Blood Banking

Saneha Anjum Shaikh, Transfusion Medicine Specialist, shared a post on LinkedIn:

“Why Antibody Screening Must Be Standard Practice in Modern Blood Banking: A Case That Speaks for Itself

A patient with transfusion-dependent thalassemia presented for routine red cell transfusion. ABO/Rh typing was straightforward, and crossmatching initially appeared compatible.

However, routine pre-transfusion antibody screening detected an unexpected clinically significant alloantibody. Further antibody identification revealed specificity against a common red cell antigen.

Antigen-negative donor units were selected, and the patient was transfused safely without adverse events.

Now consider the alternative.

Without antibody screening, transfusion of antigen-positive red cells could have resulted in a delayed hemolytic transfusion reaction, poor post-transfusion hemoglobin increment, accelerated destruction of donor red cells, additional alloimmunization, and increasing difficulty in sourcing compatible blood for future transfusions.

This scenario is not uncommon.

Patients exposed to foreign red cell antigens through repeated transfusions or pregnancy are at risk of developing clinically significant alloantibodies, particularly those directed against antigens in the Rh, Kell, Duffy, Kidd, and MNS blood group systems.

Many of these antibodies are undetectable by ABO/Rh typing alone but are readily identified during an indirect antiglobulin test (IAT)-based antibody screen.

Routine antibody screening offers several critical advantages:

Early detection of clinically significant alloantibodies before transfusion.
Selection of antigen-negative donor units, reducing the risk of hemolytic transfusion reactions.
Prevention of additional alloimmunization in chronically transfused patients.
Improved transfusion efficacy with better red cell survival and hemoglobin response.
Enhanced preparedness for future transfusions by maintaining comprehensive immunohematology records.
Better obstetric outcomes through identification of antibodies associated with hemolytic disease of the fetus and newborn.

As transfusion medicine evolves toward precision transfusion support, compatibility testing should not stop at ABO/Rh typing.

Comprehensive pre-transfusion testing—including antibody screening and, when indicated, antibody identification and extended phenotypic or genotypic matching—is essential for delivering safer, evidence-based patient care.

The safest transfusion is not simply ABO compatible—it is immunologically compatible.”

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