Immunohematology Reference Laboratory Services

Description of Available IRL Services

The MKBC Immunohematology Reference Laboratory (MKBC-IRL) is an AABB accredited laboratory that specializes in the identification and resolution of red cell transfusion compatibility problems. Hospitals throughout the country can utilize the services of the Reference Laboratory routinely for simple to complex serologic investigations and the provision of specialty typed red cell units for patients with a transfusion need.

The available tests and services performed in the Reference Laboratory are outlined below:

Red Cell Antibody Investigations

1. Simple and Complex Antibody Resolution
   • Warm and Cold Auto-Antibodies
   • Antibodies to High and Low-Incidence Antigens
     
   • Antibodies demonstrating High-Titer, Low-Avidity characteristics
     
   • Drug-induced Antibodies
     
   • Reagent-Dependent Reactivity
     
2. Hemolytic Disease of the Newborn Investigations
3. Transfusion Reaction Investigations
4. Aberrant or Discrepant Result Investigations
   • ABO Discrepancies
     
   • Discrepant Red Cell Antigen Typing
     
   • Weak Antigen Expression Investigations
5. Polyagglutination Investigation
6. Donor/Patient Extended Red Cell Phenotype Requests
   
7. Prenatal Evaluations (ABO/Rh, Antibody ID, Titer)
   
8. Platelet Antibody Screening and “Crossmatch Compatible” Platelets
   
9. Serologic Consultations
   
10. Procurement of Antigen-Negative Donor Units
    
11. Response to Requests for Rare Donor Units from the American Rare Donor Program (ARDP)

IRL Testing Request Process/Forms

1. Before drawing and shipping specimens, arrangements must be made with the Reference Lab to assess the nature of the problem and to determine the samples which will be required for testing. The Reference Lab can be reached at: 610-691-5850 Ext: 240
2. Complete the Reference Laboratory Request Form as thoroughly as possible. This form may be obtained by contacting the Reference Laboratory. The MKBC-IRLor ordering facility will coordinate shipping of the samples.
3. All samples must be submitted according to AABB IRL Standards.
4. Requests for rare donor units may be made by calling the IRL.

IRL Sample Requirements

Adequate sample volume must be submitted and tubes must be appropriately labeled. The volume and number of sample tubes required varies by the specific laboratory test requested. Sample requirements for tests not listed below will be determined by the IRL and the customer.

1. Sample Requirements
   • One (1) 7-mL13 x 100 mm purple top tubes - K2 EDTA-plasma
     Two (2) 10-mL16 x 100 mm red top tubes - serum + clotted red cells
     * Call the IRLif sample volume available is less than required.
     
   • If the sample volume is less than 20 mL, contact the IRL.
     
   • Specimens are acceptable for evaluation if collected within the previous three (3) days and no transfusion has occurred.
2. Labeling Requirements and Sample Suitability
   • The Reference Laboratory minimum labeling expectations are based on the Standards of the AABB. The stated criteria must be used for the safety of the patient.
   • At a minimum each patient sample tube must be labeled with
     the following information:
     • Patient first and last name
       
     • Patient identification number
       
     • Date specimen collected
     • Phlebotomist’s identification. The identification may be either initials or numeric code.
       
       NOTE: If the tube label is illegible, or if the patient data on the tube is not identical to the patient data on the Reference Laboratory Request Form, the specimen will be rejected.
       
       
3. Specimen Retention at MKBC
   • All samples submitted for evaluation will be retained for two weeks. Additional testing may be deemed necessary under some circumstances, e.g. transfusion reaction investigation.

Sample Packaging/Transport

Notify the Reference Laboratory in advance of sample arrival. Samples must be sent in protective packaging (e.g. canisters) to ensure sample stability during transport, as recommended on page 11.

Reporting of Results: Phone, Fax, Final Report

Upon completion of testing, the Reference Laboratory personnel will call the ordering facility and give a verbal preliminary report. If requested, appropriate units will be sent.

A summary of the preliminary results will also be documented on a Preliminary Report and sent to the ordering facility via facsimile. This report will outline the patient’s results for the following tests:

1. ABO/Rh
   
2. DAT
   
3. Eluate Reactivity
   
4. Serum Reactivity
   
5. Preliminary Interpretation
   
6. Transfusion Recommendations

A final Reference Lab Consultation Report will be prepared. The Reference specialist, Reference Lab Supervisor and Medical Director will review the final report. The final report will be mailed to the ordering facility within two weeks from the time testing is complete.

IRL Turn Around Time

1. Routine requests - preliminary reports within three working days.
2. A.S.A.P. - preliminary reports next working day.
3. STAT- preliminary reports same day.

Miller-Keystone Blood Center Sole Supplier of Blood to Berks, Carbon, Lehigh, Northampton, Southern Luzerne, Upper Bucks and Upper Montgomery (PA), and Warren (NJ) counties.

An Independent, Not-For-Profit 501(c)3 community organization, Miller-Keystone Blood Center is an an affiliate of Hospital Central Services, Inc.