Abstract: Objective To study the effect of intravenous immunoglobulin（IVIG）on cross-match in non-hemolytic anemia in children to discuss the best-practice transfusion strategy. Methods A total of 12 non-ABO hemolytic patients with negative antibody screening and cross-match incompatibility from January 2020 to December 2022 were included. Blood type identification was performed by tube test method. Antibody screening, cross-match, direct antiglobulin test (DAT), and anti-A and anti-B detection in free plasma and elution test were performed by microcolumn gel card method. Results After receiving IVIG, anti-A was detected in 6 type A and 2 type AB, anti-B in 3 type B, and anti-A and anti-B in 1 type AB. All patients were DAT positive, and appeared different degrees of hemolysis. Those were cross-match incompatible with same blood type suspended red blood cells, but cross-match compatible with type O washed red blood cells. Conclusion After administration of IVIG, some non-ABO hemolysis children have cross-match incompatibility and mild hemolytic symptoms, so it is advisable to choose O-type washed red blood cell.

Key words: Intravenous immunoglobulin, Hemolytic transfusion reaction, Cross-match incompatibility