Organ-Tissue Donor Recipient Panel
Label Mnemonic: ORGTMN
Epic code: LAB3766
Downtime form: A-1a Doctor/Provider Orders - Pathology Core and Specialty Care Nursery
Commercial Mailout Laboratory
6240-8 RCP
356-8593
Specimen(s):
Whole Blood, Serum and Urine (Marrow and Stem Cell Donors only)
Collection Medium:
and and and and
Pink top tube 6 mL (K2-EDTA) Pink top tube 6 mL (K2-EDTA) Pink top tube 6 mL (K2-EDTA) Red top tube 5 mL (Clot Activator) Urine
Minimum:
3 full 6 mL pink K2 EDTA top tube
1 full 6 mL red top tube
0.5 mL of clean catch urine if testing is needed
  for chlamydia/or gonorrhea is preferred (Male or Female)

Blood and/or urine once collected; must reach the reference 
laboratory within 5 days of blood draw to be tested.

MPX and WNVNAT:
° Specimen must be received within 72 hours of collection.
° Friday afternoon collection, Mailouts must be contacted
  (356-8593) M-F (8-5).
° Saturday collection is strongly discouraged.
° Do Not collect on a holiday, day before a holiday, or weekend
  before holiday.
Turn Around Time:
1 week upon receipt at reference laboratory
Reference Range:
Antibody to Trypanosoma cruzi (Anti-T.cruzi)-Red top tube
  Negative
Chlamydia trachomatis (Chlamydia)-Urine preferred or swab
  Negative
1) CMV Antibody (No reflective testing occurs)-Pink EDTA tube
   Negative (Positive result suggest current or past infection with
   Cytomegalovirus (CMV).  The presence of Anti-CMV does not assure
   immunity to the disease.)
2) CMV Total Antibody with Reflex to IgG & IgM-Pink EDTA tube
   Negative
   Positive Antibodies screens will be determined by confirmation.
   CMVTG-CMV IGG
   CMVTM-CMV IGM
This particular version of CMV testing is for gestational carriers determined by the IVF OBG Department and protocol.
Antibody to Hepatitis B Core Antigen, Total (detects IgG
    and IgM)-Red top tube
  Negative
Hepatitis B Surface Antigen-Pink EDTA tube
  Non-reactive
Hepatitis C Antibody-Pink EDTA tube
  Non-reactive
HIV 1/2 Antibody plus O-Pink EDTA tube
  Non-reactive
HTLV I/II Antibody Screen-Pink EDTA tube
  Non-reactive
MPX (HIV/HCV/HBV PCR-NAT)-Pink EDTA tube
  These 3 tests are done together, they cannot be separated out.
  Non-reactive
  *If the MPX results is negative then the associated comments will
   state that there is no evidence of exposure to HIV-1, M, O, HIV-2,
   HBV, HCV.
  *If the MPX test is positive, the results will indicate a positive.
   Further discriminary testing will subsequently be performed for
   HIV-1, HCV and HBV to identify the positive marker.
Neisseria Gonorrhoeae (Gonorrhea)-Urine preferred or swab
  Negative
Syphilis TP (TPPA)-Pink EDTA tube
  Non-reactive
West Nile Virus (WNVNAT)-Pink EDTA tube
  Negative
Comments:
CMV testing is determined by protocol. Two version exist:
1) Screen with no reflex.
2) Screen with reflex to IgG and IgM.

If you require Antibody to Trypanosoma cruzi (Anti-T.cruzi) testing (TCRUZIMN) this must be ordered on the requisition along with the ORGTMN.

If you require West Nile Virus nucleic acid testing (WNVNAT) this must be ordered on the requisition along with the ORGTMN.

These tests may be ordered only if the patient is part of the donor network, sperm, egg or embryo donor, autologous blood donor or stem cell donor.

Chlamydia/Gonorrhoeae: clean catch urine is preferred - Male or Female)
Methodology:
1) CMV antibody with no reflex: Immucor Capture-CMV-solid phase-
   automated.
2) CMV antibody with reflex to IgG and IgM: Capture-CMV-solid phase-
   automated.
Reflex CMV IgG: Chemiluminescence; ELISA II
Reflex CMV IgM: Captia Enzyme Immunoassay; ELISA II

Antibody to Hepatitis B Core Antigen, Hepatitis B Surface Antigen, 
Hepatitis C Antibody, HIV 1/2 Antibody plus O, CMV-Immucor and 
HTLV I/II Antibody Screen use Abbott Prism HTLV-1/HTLV-2 methodology 
for testing.

HIV 1/2 plus O series Antibody Immunoblot will be confirmed on any
reactive specimen.  Confirmatory scheme includes the following 
testing:  
Anti HIV-1 Western Blot (Bio-Rad Western blot), HIV-2 EIA (if Western 
blot negative) (Bio-Rad), and HIV-2 Immunoblot (if HIV-2 EIA positive) 
(Viromed).

MPX series (HIV/HCV/HBV PCR-NAT) and West Nile Virus (NAT) use Nucleic 
Acid Testing (NAT) Roche Molecular method.

Syphilis Treponema Pallidum uses microhemagglutination on the Immucor's 
NEO Treponema Pallidum System.

Trypanosoma cruzi (T. cruzi) uses Ortho EIA screening.

Confirmatory Testing:
Hepatitis B Surface Antigen Confirmation:  Neutralization confirmation 
performed by BioRad - EIA.

Hepatitis C Antibody:  Alternative Methodology - Abbott PRISM Anti-HCV

HIV-1 Group O or HIV-2.  These results should be evaluated in the 
context of the individual's risk factors and other clinical findings.
  MPX: (Roche Multiplex PCR)
  HBV-PCR: (Roche HBV-PCR)
Discriminatory testing performed at Lifesource Testing Laboratory
  HCV-PCR: (Roche HCV-PCR)
Discriminatory testing performed at Lifesource Testing Laboratory
  HIV-1PCR: (Roche HIV-1-PCR)
Discriminatory testing performed at Lifesource Testing Laboratory

Syphilis Alternative Methodology Beckman Coulter PK Treonema Pallidum 
System.

Chlamydia trachomatis (Chlamydia):  uses the Gen-Probe Amptima Combo 2 
kit; transferred by Mailouts to this kit for submission to reference 
laboratory

Neisseria Gonorrhoeae (Gonorrhea):  uses the Gen-Probe Amptima Combo 2 
kit; transferred by Mailouts to this kit for submission to reference 
laboratory.

Trypanosoma cruzi (T. cruzi) Alternative Method: Prism Chagas.
CPT Code:
Antibody to Trypanosoma cruzi (Anti-T.cruzi) EIA screen: CPT = 
86753
  T.cruzi Alternative Method: CPT = 86753

Chlamydia trachomatis CPT = 87491

CMV Antibody CPT = 86644 (screen)
Reflex CMV IgG CPT = 86644
Reflex CMV IgM CPT = 86645

Hepatitis B Core Antigen  CPT = 86704

Hepatitis B Surface Antigen  CPT = 87340
  (Hepatitis B Surface Antigen Confirmatory testing done
   automatically if positive.  CPT code =  87341)

Hepatitis C Antibody CPT = 86803
  (Hepatitis C Antibody Alternative Method testing done automatically
   if positive.  CPT code = 86804)

HIV 1/2 Antibody plus O CPT = 86703
  (HIV 1/2 Antibody Immunoblot will be confirmed on any reactive
   specimen; CPT code = 86689.  Confirmatory scheme includes the
   following testing:  Anti HIV-1 Western Blot (Bio-Rad),
   HIV-2 EIA (if Western blot negative--Bio-Rad).

MPX (HIV/HCV/HBV PCR-NAT) - Combination Test as a screen has the 
following CPT's:
   HIV = 87535
   HCV = 87521
   HBV = 87516

HTLV I/II Antibody:  HTLV I CPT code = 86687; HTLV II CPT code =
  86688 (screen only test, reflex to Alternative Methodology).  

Neisseria Gonorrhoeae CPT = 87591

Syphilis TP CPT code = 86780.  If positive, Alternative Method 
performed CPT code = 86780.

West Nile Virus (WNVNAT) CPT code = 87798