Benefits of VISION Max automated cross-matching in comparison with manual cross-matching: A multidimensional analysis

Autoři: Hee-Jung Chung aff001;  Mina Hur aff001;  Sang Gyeu Choi aff001;  Hyun-Kyung Lee aff001;  Seungho Lee aff002;  Hanah Kim aff001;  Hee-Won Moon aff001;  Yeo-Min Yun aff001
Působiště autorů: Department of Laboratory Medicine, Konkuk University Medical Center and Konkuk University School of Medicine, Seoul, South Korea aff001;  Department of Occupational and Environmental Medicine, Ajou University Medicine, Suwon, South Korea aff002
Vyšlo v časopise: PLoS ONE 14(12)
Kategorie: Research Article
doi: 10.1371/journal.pone.0226477



VISION Max (Ortho-Clinical Diagnostics, Raritan, NJ, USA) is a newly introduced automated blood bank system. Cross-matching (XM) is an important test confirming safety by simulating reaction between packed Red Blood Cells (RBCs) and patient blood in vitro before transfusion. We assessed the benefits of VISION Max automated XM (A-XM) in comparison with those of manual XM (M-XM) by using multidimensional analysis (cost-effectiveness and quality improvement).

Materials and methods

In a total of 327 tests (130 patients), results from A-XM and M-XM were compared. We assessed the concordance rate, risk priority number (RPN), turnaround time, hands-on time, and the costs of both methods. We further simulated their annual effects based on 37,937 XM tests in 2018.


The concordance rate between A-XM and M-XM was 97.9% (320/327, kappa = 0.83), and the seven discordant results were incompatible for transfusion in A-XM, while compatible for transfusion in M-XM. None of the results was incompatible for transfusion in A-XM, while compatible for transfusion in M-XM, meaning A-XM detect agglutination more sensitively and consequently provides a more safe result than M-XM. A-XM was estimated to have a 6.3-fold lower risk (229 vs. 1,435 RPN), shorter turnaround time (19.1 vs. 23.3 min, P < 0.0001), shorter hands-on time (1.1 vs. 5.3 min, P < 0.0001), and lower costs per single test than M-XM (1.44 vs. 2.70 USD). A-XM permitted annual savings of 46 million RPN, 15.1 months of daytime workers’ labor, and 47,042 USD compared with M-XM.


This is the first attempt to implement A-XM using VISION Max. VISION Max A-XM appears to be a safe, practical, and reliable alternative for pre-transfusion workflow with the potential to improve quality and cost-effectiveness in the blood bank.

Klíčová slova:

Automation – Blood – Blood transfusion – Cost-effectiveness analysis – Globulins – Indirect costs – Medical personnel – Blood banks


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2019 Číslo 12