Is a cross-match necessary before a cat’s first blood transfusion?

  • Ben Safrany MRCVS
  • Sophie Adamantos



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PICO question

In transfusion-naïve cats receiving a type specific blood transfusion is cross-matched blood (major and minor) associated with an increased haematocrit development and reduction in acute transfusion reactions when compared with those receiving non-crossmatched blood?


Clinical bottom line

Category of research question


The number and type of study designs reviewed

Ten papers were critically reviewed. There were four retrospective case series, three prospective cross-sectional surveys, a retrospective cohort study, a prospective case series and a prospective randomised control trial.

Strength of evidence


Outcomes reported

It would appear that in the United Kingdom the incidence of non-AB transfusion reactions is low.  A single study suggests that cross-matching may result in a greater improvement in haematocrit, but this is unlikely to be clinically significant. There is evidence to support the hypothesis that non-AB antigens (for example the Mik antigen) differ with geographic distribution.


Based on the information available it is it is challenging to establish a meaningful clinical conclusion on which to base a recommendation.


How to apply this evidence in practice

The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources.

Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.


Open Access Peer Reviewed


Binagia, E., Mattison, B. & Koenigshof, A. (2016). ‘Cross-matched vs non-crossmatched feline blood transfusions and effects on transfusion reaction rates, post-transfusion packed cell volume, duration of hospitalisation, and survival’, Journal of Veterinary Emergency Medicine and Critical Care, Abstract presented September 7–11, 2016 in Grapevine, TX, USA. DOI:

Goy‐Thollot, I., Nectoux, A., Guidetti, M., Chaprier, B., Bourgeois, S., Boisvineau, C., Barthélemy, A., Pouzot-Nevoret, C. & Giger, U. (2019). ‘Detection of naturally occurring alloantibody by an in‐clinic antiglobulin‐enhanced and standard crossmatch gel column test in non‐transfused domestic shorthair cats’, Journal of Veterinary Internal Medicine, 33(2), pp. 588–595. DOI:

Hourani, L., Weingart, C. & Kohn, B. (2017). ‘Alloimmunisation in transfused patients: serial cross-matching in a population of hospitalised cats’, Journal of Feline Medicine and Surgery, 19(12), pp. 1231–1237. DOI:

Klaser, D. A., Reine, N. J. & Hohenhaus, A. E. (2005). ‘Red blood cell transfusions in cats: 126 cases (1999)’, Journal of the American Veterinary Medical Association, 226(6), pp. 920–923. DOI:

McClosky, M. E., Cimino Brown, D., Weinstein, N. M., Taney, M. T., Marryott, K. & Callan, M. B. (2018). ‘Prevalence of naturally occurring non-AB blood type incompatibilities in cats and influence of crossmatch on transfusion outcomes’, Journal of Veterinary Internal Medicine, 32(6), pp. 1934–1942. DOI:

Sylvane, B., Prittie, J., Hohenhaus, A. E. & Tozier, E. (2018). ‘Effect of cross-match on packed cell volume after transfusion of packed red blood cells in transfusion-naïve anemic cats’, Journal of Veterinary Internal Medicine, 32(3), pp. 1077–1083. DOI:

Tasker, S., Barker, E.N., Day, M.J. & Helps, C. R. (2014). ‘Feline blood genotyping versus phenotyping, and detection of non-AB blood type incompatibilities in UK cats’, Journal of Small Animal Practice, 55(4), pp. 185–189. DOI:

Weingart, C., Giger, U. & Kohn, B. (2004). ‘Whole blood transfusions in 91 cats: A clinical evaluation’, Journal of Feline Medicine and Surgery, 6(3), pp. 139–148. DOI:

Weinstein, N. M., Blais, M., Harris, K., Oakley, D. A., Aronson, L. R. & Giger, U. (2007). ‘A Newly Recognized Blood Group in Domestic Shorthair Cats: The Mik Red Cell Antigen’, Journal of Veterinary Internal Medicine, 21(2), pp. 287–292. DOI:

Weltman, J. G., Fletcher, D. J. & Rogers, C. (2014). ‘Influence of cross-match on posttransfusion packed cell volume in feline packed red blood cell transfusion: Influence of cross-match on feline transfusion efficacy’, Journal of Veterinary Emergency and Critical Care, 24(4), pp. 429–436. DOI:





Vol. 5 No. 2 (2020): The second issue of 2020

Section: Knowledge Summaries

Categories :  Small Animal  /  Dogs  /  Cats  /  Rabbits  /  Production Animal  /  Cattle  /  Sheep  /  Pig  /  Equine  /  Exotics  /