Few studies have explored the cost of typing and matching RBCs for transfusions. To understand the cost of the ABO type and screen (also referred to as group and save) and crossmatch laboratory tests, researchers performed a systematic review of the literature from 2012 to 2023. Seventy-two studies in English were identified that analyzed costs of laboratory testing for RBCs: 42% (n=30) from the U.S., 32% (n=23) from the U.K., and the remainder from various other countries. The median cost of type and screen testing from 48 studies was £19.8 (IQR, £11.8 to £52.5). The cost and variation of type and screen testing was approximately four times higher in the U.S. (median £57.4; IQR, £23.5 to £123.8) than in the U.K. (median £13.8; IQR, £9.8 to £21.9). In addition, the median cost of crossmatch testing in the U.S. (£20; from 9 studies) was two-times higher than in the U.K. (£10; from 4 studies). Overall, variation was observed for the cost of typing and matching RBCs before transfusion, and few studies provided a breakdown of all costs associated with pre-transfusion testing. With the implementation of additional safety measures and integrated electronic health records, health care systems may need to re-evaluate the balance between patient safety and costs, as current guidelines recommend that all patients have two separate ABO typings before surgery.
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