No Blood Type and Cross-Match Required for Albumin 20%
Albumin 20% does not require blood typing, group and hold, or cross-matching before administration because it is a manufactured plasma derivative that has been heat-treated and pasteurized, making it free of blood group antigens and infectious agents.
Why Albumin is Different from Blood Products
- Albumin is not a cellular blood component and contains no red blood cells, white blood cells, or platelets that carry ABO or Rh antigens 1
- The manufacturing process involves pooling human plasma from thousands of donors, followed by fractionation, heat treatment (60°C for 10 hours), and pasteurization, which eliminates blood group antibodies and antigens 2
- Unlike fresh frozen plasma or packed red blood cells, albumin solutions (both 5% and 20%) are standardized pharmaceutical products with consistent composition 3, 4
Clinical Practice Standards
- Albumin can be administered immediately without any pretransfusion testing, allowing for rapid volume expansion when clinically indicated 5, 6
- The 2024 International Collaboration for Transfusion Medicine Guidelines extensively discuss albumin administration protocols without any mention of blood typing requirements, confirming this is not standard practice 1
- For spontaneous bacterial peritonitis in cirrhosis, albumin (1.5 g/kg) should be given within 6 hours of diagnosis, and delays for blood typing would be inappropriate and potentially harmful 5
Practical Implications
- Hospital blood banks do not need to be involved in albumin administration, unlike true blood product transfusions 2
- Albumin 20% can be stored at room temperature (not exceeding 25°C) in general pharmacy stock, not requiring blood bank refrigeration 6
- The only pre-administration checks needed are standard medication verification (correct patient, correct dose, correct route) and assessment for contraindications like severe anemia or heart failure 1
Common Pitfall to Avoid
- Do not confuse albumin with plasma products (fresh frozen plasma, cryoprecipitate) which DO require ABO compatibility testing 2
- Some institutions may have outdated policies requiring blood bank involvement for all "colloid" products—these should be updated to reflect current evidence-based practice 1