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 NBS, Newcastle.
Red cell phenotype 6ml EDTA
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 NBS, Newcastle.

Issues of Blood Products & 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
Platelet Investigations All samples referred to NBS.
Please use NBS form 3D
Investigation of neonatal alloimmune thrombocytopenia Maternal: 3 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 NBS, Bristol.
Please use NBS form 3E
Autoimmune neutropenia 10ml clotted
Felty’s syndrome 10ml clotted

Investigation of Transfusion Reactions

1. Local Investigations

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

2. Referred Tests

Histocompatibility & Immunogenetics Forms

Requests for investigation of Adverse Events & Reactions

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

Reference Centres

Test Referral Centre
Alloantibody investigation RCI Laboratory
NHSBT Centre Newcastle
Holland Drive
Barrack Road
ABO/Rh Grouping Problems
Extended RBC Phenotype
AIHA Investigation
Haemolytic Transfusion Reaction
Compatibility Testing
IgA deficiency/antibodies
Anti D/c Quantification
Paternal phenotyping
FMH quantification
HLA/HPA/HNA typing H&I Laboratory
NHSBT Centre Newcastle
Holland Drive
Barrack Road
HLA/HPA/HNA antibody screening
Investigation of platelet refractiveness
HLA and disease association
TRALI investigation
PTP investigation
Solid organ transplant HLA testing
HSCT transplant HLA testing
Severe febrile no haemolytic transfusion reaction due to HLA, HNA, HPA antibodies H&I Laboratory
NHSBT Centre Bristol
500 North Bristol Park
BS34 7QH
Foetal red cell genotyping IBGRL
500 North Bristol Park
Very complex red cell antibody identification