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April 4, 1990

Substituting Diagnostic Services

JAMA. 1990;263(13):1767-1768. doi:10.1001/jama.1990.03440130047023

To the Editor.—  Eisenberg et al1 define the blood type and crossmatch and type and screen as "substitutable tests." The type and screen characterizes the red blood cells of a particular patient/potential recipient in terms of the expression of certain major human blood group antigens and tests the same patient's serum for the presence of antibodies to a much larger group of commonly and less commonly expressed red blood cell antigens. The crossmatch, by contrast, assesses the degree of immunologic compatibility between a particular donor unit and a particular potential recipient.For many years, certainly during the study period, the type and crossmatch has included an antibody screen, and the procedure might more accurately be described as a type, screen, and crossmatch. Since pooled screening red blood cells contain a great many more kinds of antigen than are expressed on the cells within an individual donor unit, the