If a positive auto control is identified during crossmatching, what is the typical next step?

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A positive auto control in crossmatching signals the presence of an autoantibody, meaning the patient’s plasma contains antibodies that react with their own red cells and can cause broad, non-specific reactivity. The appropriate next step is to identify that antibody’s specificity by performing an antibody screen with a panel of reagent red cells and, if needed, autoreactsivity testing such as DAT or adsorption studies. Knowing the exact specificity helps determine whether there is an accompanying alloantibody that would require antigen-mnegative donor units, or if only an autoantibody is present so transfusion planning can proceed with the safest compatible or least-incompatible units. Warming the sample or simply consulting without testing aren’t adequate responses to an auto control-positive result, and switching to antigen-negative units without identifying the antibody isn’t the standard first step.