ALL Blood Transfusion samples must be hand-written in accordance with the Trust's Blood Administration Protocol

Transcription

1 Blood Transfusion Routine Investigations ALL Blood Transfusion samples must be hand-written in accordance with the Trust's Blood Administration Protocol Full Group & Screen 2ml EDTA Can be stored at 2-8C for up to 7 days, dependent upon previous transfusion history (see Hospital Blood Administration Protocol) Confirmation Group (2nd sample) 2nd Group check for new patients 0.5ml EDTA Sample will not be accepted if collected within 30 minutes of primary sample. Direct Antiglobulin Test Newborn Group and DAT Haemolysis, autoimmune investigations 1. Investigation of Neonatal Jaundice 2. With maternal sample pre transfusion 0.5ml EDTA 0.5ml EDTA May be requested with a full blood count (shared sample) Keep at Room Temperature and send to within 2 hours of collection by Air Tube or hand delivered Median Turnaround (95%) 2 hours Newborn Group andantibody Screen Where no maternal 2ml EDTA sample is available pre transfusion Can be stored at 2-8C Request as Full Group for up to 7 days, and Screen ( dependent upon will process sample previous transfusion appropriately for the history (see Hospital age of the infant) Blood Administration Protocol) Rh subgroups Blood Product Requests Presentation sample for sickle cell disease and thalassaemia major patients Additional 2ml sample (with group and screen) 2nd sample will be forwarded to NHSBT for a full antigen genotype Rh subgroups are reported with the group and screen. Extended genotype reported according to NHSBT protocols

2 Crossmatch Test As group and screen Crossmatch Neonatal Crossmatch (with maternal sample) Infants under 4 months (presentation sample) Crossmatch Octaplas Issue Correction of coagulopathy Cryoprecipitate Issue Correction of fibrinogen deficiency Platelet Issue Granulocyte Issue To correct platelet deficiency For immunocompromised patients at risk of acute infection As group and screen Transfusion Reaction Investigation Following a transfusion reaction Post Transfusion sample 4ml EDTA Refer to Trust protocol for investigation of a transfusion reaction 2-8C Keep at Room Temperature and send to within 2 hours of collection by Air Tube or hand delivered Degree of investigation is dependent upon the complexity of the initial results (within 2hrs of receipt). No specific turnaround time indicated for final report. Blood Transfusion Reflex Investigations (Laboratory instigated investigations) Antibody Panel Following a positive antibody screen 2 x 4mL EDTA ( generated) (Internal only) Discuss directly with staff NB: Positive results may be As full group and referred to NHSBT RCI screen for investigation/confirma tion Internal Only

3 Monospecific DAT Following a positive DAT (Internal Only) Positive results may be followed up with a repeat DAT on a weekly/monthly basis according to clinical See DAT need NB: Positive results may be referred to NHSBT RCI for investigation/confirma tion See DAT Specialist immunology Samples Refererred directly to NHSBT HLA Type and antibody screen To investigate platelet refractoriness (Initial nvestigation) Drug Hypersensitivity/Disease Association TRALI Investigation - Record all units transfused in the last 24 hours By Courier directly to Histocompatibility and Immunogenetics (H&I) Filton, Bristol

4 Transfusion Reaction Investigation To investigate Transfusion-associated Graft versus host Discuss directly with disease (TaGVHD) NHSBT H&I consultant NHSBT request Form Discuss directly with NHSBT H&I consultant By Courier directly to Histocompatibility and Immunogenetics (H&I) Filton, Bristol Transfusion Reaction Investigation Discuss directly with NHSBT Medical To Investigate severe consultant febrile non-haemolytic transfusion reaction NHSBT request Form Discuss directly with NHSBT medical consultant By Courier directly to Histocompatibility and Immunogenetics (H&I) Filton, Bristol HLA Typing (Solid organ Transplant) Pre solid organ trnasplantation - renal, HLA type liver/small bowel, HLA specific antibodies cardiothoracic, corneal 3B HLA Typing (Haematopietic Stem Cell Transplant) HSCT Patients and donors HLA type 3C Platelet Immunology (Autoimmune) 3D Samples must be <72 Platelet Immunology(HIT Screen) To investigate Heparin induced Thrombocytopenia 3D

5 Platelet Immunology(Other Drugs) 3D (A sample of the implicated drug together with the pharmacological concentration used HPA Typing and antibody screen To investigate platelet refractoriness (NB: HLA testing must be carried out first) and 18mL EDTA 3D Fetal/Neonatal Alloimmune Thrombocytopenia (NAIT screen) 1mL EDTA (Baby) 6mL EDTA (Father) 6mL EDTA (mother) Separate form 3D for each individual Post Transfusion Purpura(PTP) 3D (Pre and post transfusion count results) Neonatal Alloimmune Neutropenia (NAIN) 1mL EDTA (Baby) 6mL EDTA (Father) 6mL EDTA (mother) 3E State delivery date/edd length of gestation neonatal and maternal platelet counts Separate form for each individual EDTA samples must be kept at room temperature and arrive at the Bristol within 24hours of collection Courier to Platelet and NHSBT Filton, Bristol

6 Anti Neutrophil Antibodies To investigate autoimmune neutropenia Infants 2mL clotted 2mL EDTA Older children 6mL clotted 3E EDTA samples must be kept at room temperature and arrive at the Bristol within 24hours of collection NHSBT Filton, Bristol Drug induced antibody mediated neutropenias 3E (A sample of the implicated drug together with the pharmacological concentration used) Discuss with Bristol before collecting sample Can be stored at 2-8C prior to sending NHSBT Filton, Bristol Red cell Genotyping Anti A,B Titres For newly diagnosed sickle cell anaemia and thalassaemia major Transplant Surgery - to measure levels of patient or donor antibodies 4mL EDTA Friday) - to International Blood Group Reference Laboratory NHSBT Filton, Bristol ABO/Rh grouping investigations Extended Rbc phenotyping Investigation of anomolies found during routine investigation (e.g. weak D investigation) Where a patient is likely to require regular (e.g. monthly) transfusions for life

7 AIHA investigation Haemolytic Transfusion Reactions IgA deficiency/antibodies Haemolytic disease of the newborn Paternal phenotying Investigation of an unexplained positive DAT Investigation of unexplained haemolytic transfusion reaction