Pre-Transfusion Special Testing Order
Epic Lab Code: LAB7415
DeGowin Blood Center - Blood Bank
C271 GH
356-2561
Specimen(s):
Call laboratory for specimen requirements (319-356-2562).
Turn Around Time:
Varies Upon Request
Comments:
This test is to be used to place orders for blood products when special requirements need to be met. The order includes several questions for the provider to answer which will help the blood bank determine what testing is required, how many products are needed and when they need to be available. This test should be used when ordering the following: •Red Blood Cell (RBC) units for a patient with Red Blood Cell Antibodies and future transfusion needs. •RBC units for patients with special red cell antigen needs. •Platelets for patients who are refractory to transfusion. •Blood products for patients with severe allergies to blood transfusion (i.e. IgA deficient). For patients with RBC antibodies, specify whether the request is for a liver transplant, ABO incompatible heart transplant, a RBC exchange or routine anticipated RBC requirements. Indicate the number of units requested and when the units are needed. Select Not applicable for all other product requests. Note: RBC units are not routinely crossmatched for patients with antibodies unless they are ordered through a Pre-Transfusion Special Testing Order. For patients with special red cell antigen needs, select Anticipated RBC Requirements, specify the number of units requested and when they will be needed. Select Not applicable for all other product requests. For patients with platelet antibodies, select Crossmatched/HLA Matched. Indicate the number of units requested and when they will be needed. Select Not applicable for all other product requests. Platelet Crossmatch is used for patients refractory to platelet transfusion to determine whether a platelet is more likely to provide a good platelet increment in that patient. This is generally performed after the platelet antibody screen has been positive. In some cases, identification of HLA specific antibodies may assist in the identification of platelets for transfusions. This testing is ordered separately and performed by an outside reference laboratory. HLA matched platelets take 3-5 days and are generally ordered after the platelet antibody screen and crossmatch have failed to identify compatible platelets. HLA platelets can only be provided if the patient's HLA type is known. Many patients are refractory to platelet transfusion for non-immune causes such as DIC, bleeding, splenomegaly, regardless of the results of this test. No one test is capable of detecting all antibodies to platelets. Our experience indicates that crossmatch compatible platelets only give good responses in about 1/3 of patients. Please Note: Platelet Crossmatching and HLA matched platelets must be approved by the Clinical Pathology Resident at pager #3404. Contact the Pathology Resident to determine if Crossmatched or HLA Matched platelets are appropriate. In rare circumstances, patients may require washed blood. Examples include infusions of large volumes of blood rapidly into small children/neonates. Select Washed under Special Requirements and indicate when the products are needed. Select Not applicable for all other product requests. For patients with severe allergies to blood transfusion, indicate Washed (for RBC and platelet products) or IgA Deficient (for plasma only products) and indicate when the products are needed. Select Not applicable for all other product requests. Note: Obtaining IgA Deficient plasma may take several days as it requires documentation of IgA deficiency and possibly IgA antibodies. Contact the Clinical Pathology Resident at pager #3404 to discuss the process for qualifying the patient for IgA Deficient plasma and obtaining the product.