Abstract: Objective To analyze the efficacy of transfusion in patients with mismatched red blood cells caused by auto-antibodies, thus providing evidence for clinical safety and rational transfusion. Methods The clinical records and blood transfusion data of 35 patients with incompatible transfusion due to positive autoantibodies from May 2021 to June 2022 in our hospital were collected and statistically analyzed. Results A total of 60 transfusion applications had been made by 35 patients, 4 of which were rejected. Among 56 incompatible transfusions, 52 (92.9%) were found to be effective. There was no significant increase in TBIL after transfusion. No significant difference was observed in efficacy between transfusion of washed erythrocytes and that of non-washed erythrocytes (P>0.05). All patients had no transfusion reactions. Conclusion In case positive autoantibodies lead to blood mismatch, transfusion of ABO and Rh homologous red blood cells is safe and effective, whose primary agglutination strength is not higher than that of self-agglutination. It is advisable for blood transfusion departments to enhance doctor-patient communication to avert medical accidents; simultaneously, efforts should be made for more studies to prevent autoantibodies from affecting pre-transfusion tests.

Key words: Blood transfusion, Autoantibodies, Autoimmune hemolytic anemia (AIHA), Cross matching