Red cell investigations
| Test | Sample requirements | Comments |
|---|---|---|
| Group & save | 6ml EDTA Paediatric 1ml | |
| Cross match | 6ml EDTA Infant > 4 months 1ml | |
| Cross match: infant < 4 months | Maternal 6ml EDTA Infant 1ml EDTA samples required for first cross match only | Subsequent small volume requests for blood up to 4 months of age – no sample required unless maternal antibodies detected or infant with positive DAT. |
| DAT (Coombs Test) | 6ml EDTA Paediatric 1ml | |
| Kleihauer | 6ml EDTA | RH neg pregnant females after 20 weeks gestation. Post delivery samples should be taken 30-45 min after delivery. RH pos females – Consultant request only; if >20 weeks & RTA/assault & IUD of unknown cause. |
| Anti D/c quantitation | 6ml EDTA | Sample referred to NHSBT, Newcastle. |
| Red cell phenotype | 6ml EDTA | |
| Fetal RhD Screening | Maternal blood: 6ml EDTA | Sample referred to IBGRL, Bristol |
| Fetal genotype PCR | Maternal blood: 16ml EDTA Paternal blood: 3ml EDTA | After 16 weeks gestation. Please contact lab for advice. Sample referred to IBGRL, Bristol |
| Extended red cell investigations | 6ml EDTA x 2 | Sample referred to NHSBT, Newcastle. |
Issues of blood products and factor concentrate
| Test | Sample requirements | Comments |
|---|---|---|
| Requests for FFP, cryoprecipitate & platelets | No sample required if blood group known. If unknown please send EDTA sample for G&S as above. Blood Transfusion request form required. | Please allow 30 mins thawing time for frozen products. |
| Requests for batched products (Factor VIII, Factor IX, Novoseven, Beriplex etc) | No sample required. Blood Transfusion request form required |
Investigation of transfusion reactions
Forms required for investigation of transfusion reactions can be found on the staff intranet: Requests for investigation of adverse events & reactions
| Test | Sample requirements | Comments |
|---|---|---|
| All transfusion reactions (including severe febrile non haemolytic reactions & haemolytic transfusion reactions) | 10ml EDTA Return complete giving set & implicated unit of blood to transfusion laboratory. First MSU passed after reaction to transfusion laboratory | Please send samples to biochemistry for bilirubin and blood culture samples to microbiology |
Referred tests
NHSBT Histocompatibility & immunogenetics forms
| Test | Sample requirements | Comments |
|---|---|---|
| HLA Type Haematopoietic Stem Cell Transplantation (Patients & Donors) | 6ml EDTA See Reverse of Form | Form 3A Form 3C |
| Severe Non haemolytic transfusion reactions | 2 x 6ml clotted 2 x 6ml EDTA patient | Form 3A |
| TRALI | Pre transfusion sample 2 x 6ml clotted 2 x 6ml EDTA patient | Form 3A Donation numbers of all products transfused <24 hours before event required |
| Ta GyHD | Please discuss | Form 3A |
| Haemolytic transfusion reaction | Pre transfusion sample 7ml EDTA + 10ml clotted | Form 1A |
| Anaphylaxis/IgA deficiency | 7ml EDTA | Form A1 |
| Platelet Investigations | All samples referred to NHSBT Bristol. Please use NHSBT form 3D (Forms available in Laboratory) Samples need to arrive within 72 hours of venesection. |
|---|---|
| Investigation of neonatal alloimmune thrombocytopenia | Maternal: 1 x 6ml EDTA + 6ml clotted Paternal: 3 x 6ml EDTA Infant: 1ml EDTA |
| Platelet refractoriness | 6ml EDTA 6ml clotted |
| Autoimmune thrombocytopenia | 3 x 6ml EDTA 6ml clotted |
| Post transfusion purpura | 6ml EDTA 6ml clotted Please send direct to Bristol H&I Laboratory |
| Granulocyte Immunology | All samples referred to NHSBT, Bristol. Please use NHSBT form 3E (Forms available in Laboratory) Samples need to arrive within 24 hours of venesection. |
|---|---|
| Autoimmune neutropenia | 10ml clotted |
| Felty’s syndrome | 10ml clotted |