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Red cell reference tests and availability

Published on 30 January 2019

Red cell investigations are available at our laboratories in Aberdeen, Edinburugh and Glasgow.

Our red cell investigation labs operate from 9am to 5pm, Monday to Friday.

Our services, with a reduced staff and a limited number of tests, are also available outside routine hours.

Find your local lab.

Antibody identification

When an antibody screen is positive further identification tests will be carried out to determine the antibody specificity and significance, and to detect atypical red cell antibodies that may cause transfusion reactions.

Antenatal patients with clinically significant red cell antibodies require regular monitoring of their antibody titre.

  • A 4.5ml EDTA sample is required, with results reported in up to three working days for result.
  • Antibody investigation with provision of compatible red cells results and crossmatch will be reported in one working day.
  • Available in Aberdeen, Dundee, Edinburgh, Glasgow and Inverness.

Antibody quantitation

Quantitation is carried out on antenatal samples with antibody specificities of anti-D or anti-c.

When these antibodies are detected they will be reported first as an antibody titration value then quantified in international units.

These antibodies and anti-K are considered the most likely to cause hemolytic disease of the fetus and newborn (HDFN). The quantitation value correlates better with the risk of intravascular haemolysis.

  • A 4.5ml EDTA sample is required, with results reported in seven days.
  • Available in Edinburgh.

Anomalous ABO/D group investigation

The accurate determination of the ABO/RhD blood group is essential to safe blood transfusion practice.

  • A 4.5ml EDTA sample is required, with results reported in one to seven working days.
  • Available in Aberdeen, Dundee, Edinburgh, Glasgow and Inverness.

Transfusion reaction

In the event of a suspected transfusion reaction, the transfusion should be stopped and the relevant clinicians informed.

  • A 4.5ml EDTA sample (pre and post reaction) , 10ml clotted post sample and any RCC (used or unused) are required.
  • Results will will reported within one hour of receipt of the implicated unit(s) and post transfusion G&S sample.
  • Available in Aberdeen, Dundee, Edinburgh, Glasgow and Inverness.

Transfusion reactions - things to consider

  • All hospitals will have a local transfusion reaction policy that you should refer to.
  • All patients receiving a blood transfusion should be monitored for adverse reactions.
  • Observations of blood pressure, pulse, temperature and respiratory rate should be measured at baseline and at 15 minutes after the start of the transfusion.
  • Observations should continue periodically based on the local transfusion policy.
  • If a patient becomes unwell during or after the transfusion the transfusion should be stopped, the patient assessed and medical advice sought immediately.
  • The blood bank and/or local haematology team should be contacted for advice on management and investigations.
  • All hospital will have a local transfusion reaction form.
  • You should use the local transfusion reaction form to document the details of the reaction. A summary of events should be included in the patient’s hospital record.
  • Report the transfusion reaction to the local blood bank and transfusion practitioner.

Red cell phenotyping

Patients demonstrating previously undetected clinically significant antibodies will be typed for the corresponding antigens.

Rh/K or extended phenotyping can also be performed on paternal, AIHA, bone marrow transplantation, thalassaemia and sickle cell patients.

  • A 4.5ml EDTA sample is required, with results reported within one working day.
  • Available in Aberdeen, Dundee, Edinburgh, Glasgow and Inverness.

Red cell genotyping

Determination of extended red cell genotype for patients unable to be typed using traditional red cell serology - for example, patients with positive DAT or having recently received red cell transfusions.

  • A 4.5ml EDTA sample is required, with results reported within six days.
  • Available in Edinburgh.

Cold agglutinin

Cold agglutinins are cold reactive autoantibodies that can cause haemolytic anaemia in cold agglutinin disease.

Testing determines a temperature range and concentration of cold agglutinins.

Tests require a warm so samples must be placed in a flask at 37 degrees cenlsius immediately after collection.

  • A 4.5ml EDTA sample and 10ml Clotted sample are required by special arrangement only.
  • Results are reported within one working day.
  • Available in Aberdeen, Glasgow, Dundee and Edinburgh.

Auto Immune Haemolytic Anaemia (AIHA)

In cases of warm type AIHA the presence of broad undefined free auto-antibody may mask the presence of underlying allo-antibodies.

  • 3 x 4.5ml EDTA samples are required, with results reported within 1 working day.
  • Available in Aberdeen, Dundee, Edinburgh and Glasgow.

Direct Antiglobulin Test (DAT)

Used to determine whether patient’s red cells are coated in vivo with immunoglobulin, complement or both.

Positive DAT may be associated with shortened red cell survival or auto immune haemolytic anaemia (AIHA).

  • A 4.5ml EDTA sample is required, with results available within 30 minutes.
  • Available in Aberdeen, Dundee, Edinburgh, Glasgow and Inverness.

Paternal investigation

Paternal phenotype should be tested where a pregnant woman has an antibody capable of causing HDFN (particularly anti-D, anti-c or anti–K).

Determination of the father’s phenotype helps predict the probability of the foetus carrying the relevant red cell antigen.

  • 4.5ml EDTA sample is required, with results reported within three working days.
  • Available in Aberdeen, Dundee, Edinburgh, Glasgow and Inverness.

Elution studies

Elution is a procedure for the recovery of antibody bound to red blood cells.

This can be used in cases of suspected delayed haemolytic transfusion reactions, where the causative antibody may be absent from the plasma having been taken up by the transfused red cells.

  • A 4.5ml EDTA sample is required, by special arrangement only.
  • Results are reported within one working day.
  • Available in Aberdeen, Dundee, Edinburgh and Glasgow.

Fetal typing from maternal blood

Fetal typing may be required when a pregnant woman has a clinically significant antibody of high concentration, the woman has a history of HDFN and the father is heterozygous for the relevant antigen.

Testing will determine fetal blood group from fetal DNA in maternal plasma using PCR assay.

Assays available for RhD, Rhc, RhE, K (Kell), RhC.

  • 2 x 7ml maternal and paternal samples are required
  • Available in Aberdeen.