Is routine crossmatching for two units of blood necessary in elective surgery?

The usual preparation for many elective procedures calls for typing and crossmatching for 2 units of blood. Most of the blood prepared is not used. Every unit of blood kept for a specific patient is removed from the blood bank pool, thereby reducing its resources. Fourteen hundred of the most frequent elective operations were examined with regard to their blood utilization. A transfusion index was developed to determine whether preoperative crossmatching was justified. Applying the index to 1,400 elective procedures, it was found that only vascular procedures justified preoperative crossmatching. The safety of transfusion (elective and emergency) based on type and antibody screening is explained. The constant increase in blood consumption (as for open heart surgery) and the small increase in blood donations has created a blood shortage. It is suggested that surgeons stop requesting crossmatching for 2 units for those elective procedures in which blood is rarely used. This would decrease the workload in the blood bank and increase the blood bank pool without compromising patients' safety.