QUICK REFERENCE TO BLOOD BANK TESTING

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Theodora Davis
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1 QUICK REFERENCE TO BLOOD BANK TESTING All Blood bank Tests are performed on demand 24 hours a day, 7 days a week. Feto/Maternal Bleed Quantitation estimates will be available within 4 hours of blood bank receiving a specimen. Quantitation of any detected bleed will be available within 36 hours of blood bank receiving a specimen. Specimens which do not contain clinically significant unexpected antibodies may have results available within one hour if ordered STAT and within four hours if ordered routine. Specimens containing clinically significant unexpected antibodies may have preliminary results within four hours, but may be extended to three days depending on the complexity of the antibodies involved. ABO/RH TYPE (BLOOD GROUP) Description: Determination of the patient s ABO group and Rh type NOTE: Weak D patients will be treated as Rh negative for purposes of transfusion and RhIG administration but will be considered Rh positive as a donor. Methodology: Standard test tube methodology or gel column technology for determination of ABO Group and Rh Type. ANTENATAL Rh IMMUNE GLOBULIN (ANTENATAL RHOGAM) Description: Determination of the patient s ABO group and Rh type and interpretation of the indirect coombs test for candidacy for the administration of Rh Immune Globulin at the 28 th week of pregnancy. The test is also used for bleeding or miscarriage that occurs before 20 weeks of gestation. determination of ABO Group and Rh Type and interpretation of the indirect coombs test. ANTIBODY IDENTIFICATION Description: Determination of the specificity(ies) of the alloantibody(ies) or auto-antibodies detected in the indirect coombs test or antibody screen test.. deter-

Quantitation of any detected bleed will be available within 36 hours of blood bank receiving a specimen.

2 mination of the specificity(ies) of the antibody(ies) detected in the patient s serum. This procedure will include both IgG and IgM class antibody identifications if indicated. ANTIBODY SCREEN Description: Determination of the presence of clinically significant unexpected antibodies Methodology: Standard test tube methodology or gel column technology to determine the presence of clinically significant unexpected antibodies ANTIBODY TITRATION (TITER) Description: Serial test tube dilution technique used to determine the titer of an antibody present in the patient s plasma. This test is most often performed on the plasma of pregnant women which contains an antibody(ies) implicated in causing Hemolytic Disease of the Newborn (HDN). Testing may be repeated at intervals throughout the pregnancy to monitor for a significant increase in titer or score. Antibody Titration is also performed to confirm the presence HTLA antibodies and for IgM class antibodies in patients who undergo hypothermic surgical procedures. Methodology: Standard albumin, saline test tube methodology or gel column technology for determination of the antibody titer of a clinically significant unexpected antibody(ies) in the patient s plasma or serum. ANTIHEMOPHILIC FACTORS (LYOPHILIZED FOR INFUSION) Description: Lyophilized coagulation factors used to treat specific coagulation (factor) deficiencies. Available factors include: VIIa, VIII, IX, and vwf. Methodology: No testing is performed on this order.

presence of clinically significant unexpected antibodies ANTIBODY TITRATION (TITER) Description: Serial test tube dilution technique used to determine the titer of an antibody present in the patient

3 CORD BLOOD STUDIES Description: Determination of the newborn s ABO group and Rh type and the detection of the presence of passively acquired antibody(ies) coating the infant s red blood cells. Elution studies will be performed if indicated. determination of ABO Group and Rh Type and for the detection of the presence of passively acquired antibody(ies) coating the infant s red blood cells. Elution studies will be performed if indicated. CROSSMATCH (COMPATIBILITY TESTING) Description: Testing is performed with the intended recipient s plasma and the donor s red blood cells. The methods used will demonstrate ABO incompatibility and will include antiglobulin phase testing if clinically significant unexpected antibody(ies) are detected in the antibody screen or if there is a history of clinically significant unexpected antibody(ies) documented. determination of ABO Group compatibility and the selection of the appropriate antigen negative units by antiglobulin phase testing if clinically significant unexpected antibody(ies) are present or a history of clinically significant unexpected antibody(ies) is documented. DIRECT COOMBS TEST or DIRECT ANTIGLOBULIN TEST (DAT) Description: A test used to detect the presence of IgG class antibodies or complement coating the patient s own red blood cells or recently transfused red cells. The antibodies may be passively acquired or actively produced allo or autoantibodies. The appropriate elution studies will be performed on all positive tests as indicated. detection of the presence of antibody(ies) or complement coating the red blood cells. Elution studies will be performed if indicated. DRAW AND HOLD Description: A specimen is collected and held in the Blood Bank for future testing if specific Blood Bank orders become necessary.

Elution studies will be performed if indicated. CROSSMATCH (COMPATIBILITY TESTING) Description: Testing is performed with the intended recipient s plasma and the donor s red blood cells.

4 Methodology: No testing is performed on this specimen until the blood bank receives additional verbal instruction. FETO/MATERNAL BLEED QUANTITATION Description: A postpartum specimen from Rh Negative women is analyzed to detect the presence of a Feto/Maternal hemorrhage. The test is used to calculate the appropriate dose of Rh Immune Globulin required to provide protection from immunization and the formation of anti-d following exposure to Rh Positive red blood cells. This test may also be performed on both Rh Positive and Rh Negative pregnant women following trauma. Methodology: A modified Kleihauer-Betke acid elution slide test is performed to calculate the volume of Feto/Maternal hemorrhage. INDIRECT COOMBS Description: Determination of the presence of clinically significant unexpected antibodies determination of the presence of clinically significant unexpected antibodies POST NATAL Rh IMMUNE GLOBULIN Description: Determination of the patient s ABO group and Rh type and interpretation of the indirect coombs test and a fetal bleed screen test for candidacy for the administration of Rh Immune Globulin after the birth of an Rh Positive infant. Please Note: The specimen submitted for testing must be collected 1 hour after the delivery of an Rh Positive infant. This hour allows for adequate circulation of any fetal cells. This test may also be indicated for a miscarriage that occurs when gestational age is 20 weeks or greater.

The test is used to calculate the appropriate dose of Rh Immune Globulin required to provide protection from immunization and the formation of anti-d following exposure to Rh Positive red blood cells.

5 determination of ABO Group and Rh Type, interpretation of the indirect coombs test and interpretation of the fetal screen test. The Blood Bank will perform a reflex Feto/Maternal Bleed Quantitation Test on all positive fetal screen tests. TRANSFUSION REACTION INVESTIGATION Description: The results of the Blood Bank s investigation resulting from the adverse effects of the infusion red blood cells or red blood cell components. The blood bank must be notified of any suspected transfusion reaction. Further instruction will be provided upon notification. Methodology: Standard test tube methodology or gel column technology for determination on all Pre- and Post-Transfusion specimens and components for the determination of ABO Group and Rh Type, interpretation of the antibody screen, Direct Coombs testing and any ancillary testing required to complete the investigation. A Pathologist reviews all results of the investigation. Any additional testing will be performed at the discretion of the Pathologist. TYPE AND CROSSMATCH Description: Determination of the patient s ABO group and Rh type and the determination of the presence of clinically significant unexpected antibodies in the patient s specimen. Testing is performed with the intended recipient s serum or plasma and the donor s red blood cells. The methods used will demonstrate ABO incompatibility and will include an antiglobulin phase of testing if clinically significant unexpected antibodies are detected in the antibody screen or if there is a documented history of clinically significant unexpected antibodies. determination of ABO Group and Rh Type, determination of the presence of clinically significant unexpected antibodies, ABO Group compatibility and the selection of the appropriate antigen negative units utilizing an antiglobulin phase of testing if clinically significant unexpected antibodies or a history of clinically significant unexpected antibodies is documented. TYPE AND INDIRECT COOMBS

TRANSFUSION REACTION INVESTIGATION Description: The results of the Blood Bank s investigation resulting from the adverse effects of the infusion red blood cells or red blood cell components.

6 Description: Determination of the patient s ABO group and Rh type and the determination of the presence of clinically significant unexpected antibody(ies) in the patient s specimen. This test is ordered most often on pregnant women or for the investigation of autoimmune disease. determination of ABO Group and Rh Type and detection of the presence of clinically significant unexpected antibody(ies) in the patient s serum or plasma. TYPE AND SCREEN Description: Determination of the patient s ABO group and Rh type and the determination of the presence of clinically significant unexpected antibody(ies) in the patient s specimen. This test is ordered most often in anticipation of the possible use of blood. determination of ABO Group and Rh Type and detection of the presence of clinically significant unexpected antibody(ies) in the patient s serum or plasma. The detection of a clinically significant unexpected antibody(ies) will require the Blood Bank to identify the antibody(ies) and crossmatch two units of blood for the patient.

determination of ABO Group and Rh Type and detection of the presence of clinically significant unexpected antibody(ies) in the patient s serum or plasma.

Time Frame 15 minutes. Student should strive to be able to perform multiple procedures simultaneously.

Time Frame 15 minutes. Student should strive to be able to perform multiple procedures simultaneously. Name Direct Antiglobulin Test (DAT) (Direct Coombs) Principle The DAT detects the in vivo sensitization of RBC with IgG incomplete or non-agglutinating antibodies. After thorough washing of RBC with saline