Basingstoke and north hampshire hospital pathology user handbook

Problem	Common causes
Effect
Inappropriate collection site	Sample taken from drip arm	Will dilute any antibody present which may be missed on the crossmatch
Incorrect tube fill/mixing	Failure to adequately mix the sample	May result in clots in the sample making it invalid for crossmatching
Delay in sending the sample to the laboratory	overnight storage delay in transit	May reduce some antibody activity, or cause haemolysis making the sample unsuitable for testing
Haemolysis	Expelling blood through a needle into the tube Vigorous shaking Extremes of temperature	Haemolysed samples are unsuitable for crossmatching
Incorrect container or anticoagulant	Plain bottle, or any bottle other than an EDTA sample	Unsuitable for testing
Sample taken from wrong patient	Bad phlebotomy technique, / patient identification	Wrong blood which could lead to clinical incident

Tests carried out
-Full ABO cell and serum grouping and rapid ABO cell grouping

-Full Rh D grouping with two anti D's and rapid spin Rh D grouping

-Partial D testing and genotyping when appropriate, but not routinely

-Antibody screening by gel column technology

-Kleihauer tests

-Direct Coombs test, broad spectrum and split fractions

-Cross matching

-Identification of atypical blood group antibodies.

-Antibody titres

-Cold agglutinin titres

-Donath Landsteiner test

-Haemolysin tests

-Preparation and examination of eluates

-Examination and identification of drug related antibodies

-Group A sub typing, i.e. A2, A3, Ax.

-Autoabsorption tests for auto immune haemolytic anaemia

Turnaround Times 24 hrs
Emergency Crossmatch 20 minutes

Full Crossmatch 60 minutes

Full Crossmatch from a Group and Save 30 minutes

The following tests are referred to the National Blood Service at Filton:

-Difficult antibody investigations and rare blood group confirmations

-Quantitation of Anti-D and Anti-c

Allo absorbtion tests fro Auto immune haemolytic anaemia
Routine Request Turnaround Times 10 days

Urgent Request Turnaround Times 12 hours

Sample Reception

NHS Blood and Transplant – Filton

FAO: Red Cell Immunology

500 North Bristol Park

Filton

Bristol RB34 7QH

The Following Test is sent to the Blood Group Reference Laboratory
-Foetal Grouping
Turnaround Times 14 days
Dr Peter Martin

International Blood Group Reference Laboratory

500 North Bristol Park

Filton

Bristol RB34 7QH
The following tests are referred to the Histocompatibility and Immunogenetics Laboratory at the National Blood Service Tooting
-White cell and platelet antibodies

-HLA B27 - Monday till Thursday

-Other Specific HLAs – Monday - Thursday

-HLA typing - only by prior arrangement.

Turnaround times 21 days
Sample Reception

National Blood Service - Tooting Centre

FAO: Histocompatibility and Immunogenetics

Cranmere Terrace

Tooting

London SW17 0RB

Request card and sample requirements
All request cards and samples submitted to the Blood Transfusion Department must be correctly filled in with three points of identification:

• 
  full name
  
• 
  date of birth
  
• 
  hospital number/ NHS number/AE number and/or first line of address