ABO Group, Rh type, and antibody screen

Routine: 2 hours
Urgent: 1 hour

Available 24 hours a day.

6.0 mL blood in a LAVENDER top tube. Specimen stability: up to 3 days at room temperature.
See link for instructions for identification and labeling of Transfusion Service specimens. 
Sample Information (Opens in a new window)

Less than 4 months old: 1 to 2 mL in a LAVENDER top tube.
4 months to 3 years: 2.0 mL in a LAVENDER top tube.
Specimen stability: up to 3 days at room temperature.

Antibody screen negative.

Used for patients unlikely to require red blood cell or whole blood transfusion. Testing includes ABO, Rh, and antibody screen. Crossmatched blood is available within 10 minutes with a negative type and screen. Positive type and screens are automatically converted to an antibody identification with two compatible units identified and crossmatched. A crossmatch can be ordered for up to 3 days using sample. In Pre-op cases if patient has not been transfused or pregnant in the last 3 months, the specimen may be extended up to 30 days, upon request.

Do Not Crossmatch
Type & Screen
Type and Antibody Screen
Type and Screen Specimen

Tube held, not processed, unless additional orders are received.

Available 24 hours a day.

6.0 mL blood in a LAVENDER top tube. Specimen stability: up to 24 hours at room temperature.
See link for instructions for identification and labeling of Transfusion Service specimens. 
Sample Information (Opens in a new window)

Less than 4 months old: 1 to 2 mL blood in a LAVENDER top tube.
4 months to 3 years: 3 mL blood in a LAVENDER top tube.
Specimen stability: up to 24 hours at room temperature.

Sample is received, logged, assessed for acceptability for pre-transfusion testing (submitting location is notified if sample is not acceptable).

BB Tube-Held-Dont Process
Blood Bank Hold
Hold

Routine: 2 hours
Urgent: 1 hour

Available 24 hours a day.

Interpretive report provided.

6.0 mL blood in a LAVENDER top tube. Specimen stability: up to 3 days at room temperature.
See link for instructions for identification and labeling of Transfusion Service specimens. 
Sample Information (Opens in a new window)

Less than 4 months old: 1 to 2 mL in a LAVENDER top tube.
4 months to 3 years: 2.0 mL in a LAVENDER top tube.
Specimen stability: up to 3 days at room temperature.

In addition to the required tests on mother/infant (ABO, Rh Antibody Screen or Maternal Rh including Du on infant) to establish need for & dose of Rh Immune Globulin (RhoGAM), this workup summarizes these results and states whether the mother requires Rh Immune Globulin. Post-delivery sample or gestation information required. Will include fetal screen when indicated to screen for excessive fetal-maternal hemorrhage. RHIG is issued through Pharmacy.

Rh Immune Globulin

ABO group, Rh type, and antibody screen

Routine: 2 hours
Urgent: 1 hour

Available 24 hours a day.

Adult N/A

Less than 4 months old: 1 to 2 mL blood in a LAVENDER top tube. Specimen stability: up to 3 days at room temperature.
See link for instructions for identification and labeling of Transfusion Service specimens. 
Sample Information (Opens in a new window)

Pre-transfusion testing for patients less than 4 months. Patients with high hematocrits or with antibodies may require additional specimens. Pre-transfusion testing is performed, and 2 units which would be appropriate for the patient are located. No crossmatching is performed unless blood is subsequently ordered.

ABO Group, Rh Type, and IgG Direct Coombs

Routine: 2 hours
Urgent: 1 hour

Available 24 hours a day.

UMBILICAL CORD BLOOD: 2 to 4 mL blood in a LAVENDER top tube. Specimen stability: up to 3 days at room temperature.
See link for instructions for identification and labeling of Transfusion Service specimens. 
Sample Information (Opens in a new window)

2.0 mL blood in a LAVENDER top tube. Specimen stability: up to 3 days at room temperature.

Cord blood is routinely collected and requested as "hold, don’t process". Routine or specific testing may be ordered initially or any time up to 1 week on stored specimens.

If the Direct Coombs is positive, the Transfusion Service calls the patient location immediately. A positive Direct Coombs on a cord sample is consistent with maternal antibody adsorbed to infant red cells and suggests continued monitoring of the infant for signs of shortened red cell survival. The severity of hemolytic disease of the newborn varies markedly with the blood group system involved and with individual mother/baby pairs, and although most commonly subclinical, the disease can produce significant hyperbilirubinemia with or without significant anemia. This is especially true if the infant has additional risk factors. Eluates to determine the specificity of the antibody are performed only on specific physician request.

Complement and IgG antihuman globulin.

Routine: 2 hours
Urgent: 1 hour

Available 24 hours a day.

6.0 mL blood in a LAVENDER top tube. Specimen stability: up to 24 hours at room temperature.
See link for instructions for identification and labeling of Transfusion Service specimens. 
Sample Information (Opens in a new window)

1.0 mL blood in a LAVENDER top tube. (Additional sample may be required for elution testing). Specimen stability: up to 24 hours at room temperature.

Also known as DAT. Demonstrates the presence of immunoglobulins, complement, or protein adsorbed to red cells in vivo. Of value in the diagnosis and evaluation of hemolytic anemia, hemolytic disease of the newborn, suspected transfusion reactions, and in some diseases. Some medications can cause a positive test; rarely do such positive tests result in clinical hemolysis. Most common among the drugs reported to have caused positive direct antiglobulin tests are: Aldomet, penicillin, cephalosporins, INH, quinidine. Many hospitalized patients demonstrate weakly positive direct antiglobulin tests of no clinical significance.

Detects the presence of red blood cell-bound IgG and/or complement by agglutination using an antiglobulin (Coombs) reagent. Positive results can occur in patients with autoimmune hemolytic anemia, drug-induced immune hemolysis (e.g., alpha-methyldopa, procainamide, cepalosporins and penicillins, INH, quinidine, etc.), hemolytic transfusion reactions, or hemolytic disease of the newborn. Positive results can also occur due to non-specific IgG absorption (e.g., hypergamma-globulinemia), and occasionally in otherwise healthy individuals. Extended evaluation may include elution and absorption studies.

AHG Complement Direct Coombs
Anti-Human Globulin Test
Antiglobulin Test, Direct
Coombs, Direct
DAT
Direct Antiglobulin Test

Routine: 2 hours
Urgent: 1 hour

Available 24 hours a day.

6.0 mL blood in a LAVENDER top tube. Specimen stability: up to 3 days at room temperature.
See link for instructions for identification and labeling of Transfusion Service specimens. 
Sample Information (Opens in a new window)

Less than 4 months old: 1 to 2 mL blood in a LAVENDER top tube.
4 months to 3 years: 3 mL blood in a LAVENDER top tube.
Specimen stability: up to 3 days at room temperature.

Reflexed as appropriate as part of antibody identification. May be ordered as needed for other antigens. Specify antigen(s) as part of order, e.g. type for K.

Routine: 2 hours
Urgent: 1 hour

Available 24 hours a day.

6.0 mL blood in a LAVENDER top tube. Specimen stability: up to 7 days at room temperature for ABO/Rh only.
See link for instructions for identification and labeling of Transfusion Service specimens. 
Sample Information (Opens in a new window)

Less than 4 months old: 1 to 2 mL blood in a LAVENDER top tube.
4 months to 3 years: 3 mL blood in a LAVENDER top tube.
Specimen stability: up to 7 days at room temperature for ABO/Rh only.

Done as part of an ABO, Rh (Blood Type).
ABO type determined by presence or absence of A and B blood group antigens on red blood cells as well as presence or absence of the expected reciprocal ABO blood group antibodies in the serum.
Rh type determined by the presence or absence of the Rh (D) antigen on red blood cells using a directly agglutinating anti-D reagent. Routine weak D, antiglobulin (anti-IgG) test is not performed.

The patient's cells are tested against known antisera to establish ABO blood group and Rh type. Although the development of ABO antigens and regularly occurring antibodies is progressive during the first 18 months of life, and regressive in the last decade of life, ABO and Rh type do not change, except in non-identical marrow transplantation, or transiently if the patients are transfused with large amounts of donor blood of a group and type other than their own.

ABO and Rh Type
Type and Rh

Non-ABO antibody titers

Routine: 48 hours
Urgent: 24 hours

Monday through Friday, 07:00 to 15:30.

Interpretation depends on clinical setting.

6.0 mL blood in a LAVENDER top tube. Specimen stability: up to 3 days at room temperature or 60 days as frozen plasma.
See link for instructions for identification and labeling of Transfusion Service specimens. 
Sample Information (Opens in a new window)

Less than 4 months old: 1 to 2 mL blood in a LAVENDER top tube. 
4 months to 3 years: 3 mL blood in a LAVENDER top tube.
Specimen stability: up to 3 days at room temperature or 60 days as frozen plasma.

Antibody detection must be done first.
Semiquantitative method for determining serum concentration of clinically significant IgG (non-ABO) antibodies. Serial, two-fold dilutions of serum are tested against red cells carrying the antigen of interest (e.g., D, K) using the indirect antiglobulin method. Result is expressed as the reciprocal of the highest serum dilution that still shows (1+) agglutination. This test is used to monitor serum alloantibody levels in previously sensitized pregnant women for prenatal management of hemolytic disease of the newborn (HDN). In women with Rh alloimmunization, anti-D levels greater or equal to 16 are generally considered an indication for invasive fetal testing. For non-D antibodies, a threefold rise in titer is generally considered an indication for invasive fetal testing. Antibody titers do not always correlate with the clinical condition of the unborn child. False positives and false negatives do occur. Test will be reflexed as appropriate whenever a significant antibody is detected on a prenatal antibody screen.

Rh Titer
Titer, Blood Group Antibodies

Available 24 hours a day.

6.0 mL blood in a LAVENDER top tube. Specimen stability: up to 3 days at room temperature.
See link for instructions for identification and labeling of Transfusion Service specimens. 
Sample Information (Opens in a new window)

Less than 4 months old: 1 to 2 mL blood in a LAVENDER top tube.
4 months to 3 years: 3 mL blood, LAVENDER top tube.
Specimen stability: up to 3 days at room temperature.

This test detects the presence of unexpected antibodies (allo- or auto-) against red blood cell antigens. Patient plasma or serum is tested against a cell panel that contains common red cell antigens. The majority of clinically significant red blood cell alloantibodies are detected by this technique. If positive, an extended cell panel (antibody identification) will be performed to determine red blood cell antigen specificity.

Antibody Detection
Coombs Test, Indirect
Indirect Coombs Test