At a glance

Also known as

Compatibility test; Xmatch; CXM; Xm

Why get tested?

To enable the transfusion laboratory to select and issue the most appropriate and compatible blood for a transfusion.

When to get tested?

If your doctor indicates that transfusion with blood or blood components may be required as part of your medical treatment.

Sample required?

A blood sample drawn from a vein in the arm.

Frequency of testing?

These tests will be performed prior to receiving a blood transfusion. Where medical treatment requires ongoing transfusions over a period of time the crossmatch will be repeated every 72 hours in order to reduce the possibility of a transfusion reaction.

What is being tested?

A crossmatch is a group of tests undertaken before a person requires a blood transfusion. The transfusion laboratory completes a blood group antibody screen to establish the person's blood group and identify any possible red cell antibodies that may be present in their blood. Once completed, the transfusion laboratory then matches these results to compatible donor blood that can be safely transfused to the person.

Red blood cells have chemical structures (most commonly proteins or carbohydrates) on the outside surface of a red blood cell. These chemical structures usually have a defined function such as determining the shape of the cell or the transport of chemicals into, or out of, the red blood cell. In addition, they determine a person's blood group.

There are over 200 different blood groups known. The most important blood groups are the ABO and the RhD blood groups. However other blood groups can also become important. There are inherited blood group differences between people. When a person is exposed to blood groups that are different to their own the immune system may respond by producing a blood group antibody. This is very similar to the way we produce antibodies against germs (bacteria and viruses). The transfusion laboratory performs an antibody screen to detect and identify any blood group antibodies as these can cause transfusion reactions or haemolytic disease of the newborn (HDN).

If a transfusion is required it is important that the transfusion laboratory provides compatible blood. The blood selected for transfusion will usually lack the blood group that the person has an antibody against. A crossmatch is a final test that is performed to reduce the likelihood of a transfusion reaction. This test may be performed using laboratory tests or may be undertaken by a computer program (computer crossmatch) using results obtained from blood groups and antibody screens.

Further information on blood groups, antibody screens, crossmatching and how the tests are performed can be found in Inside the lab: Blood typing.

How is the sample collected for testing?

The crossmatch is performed on a blood sample taken by a needle placed in a vein in the arm.

The Test

How is it used?


When is it requested?


What does the test result mean?

The result allows laboratory staff to select appropriate blood for transfusion.

Common Questions

What can I do to help to prevent a transfusion?

Transfusion of red cells is to replace the oxygen carrying capacity of the body. If you start your operation with enough red cells (a high haemoglobin (Hb)) any blood loss due to a surgical procedure may result in a drop of Hb that does not require transfusion. If however you begin the operation with a low oxygen carrying capacity, (a low Hb /anaemia) then your chances of requiring a blood transfusion increase. Consult with your doctor as to how to improve your Hb in your pre-operative assessment.

What are the risks of a transfusion?

Transfusion is associated with a number of risks. You should make the decision as to whether a transfusion is required in consultation with your doctor and with an understanding of these risks. More information regarding risks can be found in Inside the lab: Blood banking risks and Australian Red Cross Blood Service: Transfusion medicine.

Can I donate blood to family members and friends, or can family members and friends donate blood for me?

Directed donations - where blood is donated for a specific person - are strongly discouraged, and in some circumstances not permitted. The safest blood (lowest risk of transfusion transmitted viruses such as HIV/AIDS and hepatitis) is that donated freely by individuals with no pressure placed on them or no incentives provided. When people feel under pressure to donate (such as for a family member) there is a possibility they may conceal important information that could be harmful to either themselves, or to the recipient of the blood. A major risk in transfusion is human error (doctors, nurses or laboratory staff inadvertently making a mistake). These risks are still present with directed donations.

Last Review Date: March 30, 2021

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