Test Details

• Discipline:

  Transfusion

  Transfusion

• Specimen Container Adult:

  6mL K2 EDTA

  6mL K2 EDTA

• Specimen Container Paediatric:

  6mL K2 EDTA

  6mL K2 EDTA

• Minimum Volume Adult:

  6mL

  6mL

• Minimum Volume Paediatric:

  2mL

  2mL

• Special Requirement:

  The Transfusion laboratory must be notified in advance that a sample for cold agglutinin investigation is required.
  Sample MUST be bagged and transported to the laboratory in a flask warmed to 37oC....

  The Transfusion laboratory must be notified in advance that a sample for cold agglutinin investigation is required.
  Sample MUST be bagged and transported to the laboratory in a flask warmed to 37oC. This can be provided by the Transfusion laboratory.
  The test can be ordered via EPR PowerChart and taken with the BloodTrack bedside sample labelling system.
  The Trust operates a zero tolerance policy. Deviation from Trust Sample Labelling Policy will result in the sample being rejected and a repeat requested.

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• Sample Stability:

  Once centrifuged and separated, short term storage: 24 hours at room temperature.
  Long term storage: 7 days at 4-6°C

  Once centrifuged and separated, short term storage: 24 hours at room temperature.
  Long term storage: 7 days at 4-6°C

• Transport Requirements:

  Sample MUST be transported directly to the Transfusion laboratory in a flask warmed to 37oC.

  Sample MUST be transported directly to the Transfusion laboratory in a flask warmed to 37oC.

• Add On Test:

  If the cold agglutinin screen is positive, the Transfusion laboratory will go on to perform a titre and thermal amplitude test.
  A cold agglutinin screen cannot be added on to a standard group and sa...

  If the cold agglutinin screen is positive, the Transfusion laboratory will go on to perform a titre and thermal amplitude test.
  A cold agglutinin screen cannot be added on to a standard group and save as the sample must be pre-warmed prior to testing.

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• Interpretation:

  Electronic Issue - EI is the selection and issue of red cell units where compatibility is determined by the LIMS without serological testing of donor cells against patient plasma. The ability to pe...

  Electronic Issue - EI is the selection and issue of red cell units where compatibility is determined by the LIMS without serological testing of donor cells against patient plasma. The ability to perform EI depends on the specific patient's transfusion and antibody history and serological status of the current sample. The BSH guidelines for the pre-transfusion compatibility procedures in blood transfusion laboratories (2012) and the BSH guidelines for the specification and use of information technology systems in blood transfusion (2006) includes detailed guidance on the testing aspects of EI. NUTH Blood Transfusion laboratories routinely perform electronic issue and have a documented contingency plan, including a validated manual process, in case of IT failure.

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• Factors Affecting Result:

  Specimen not received in laboratory within a temperature controlled flask/container or maintained at 37oC prior to separation to avoid in-vitro autoadsorption. An EDTA anticoagulated specimen not m...

  Specimen not received in laboratory within a temperature controlled flask/container or maintained at 37oC prior to separation to avoid in-vitro autoadsorption. An EDTA anticoagulated specimen not maintained at 37oC can be used in extreme circumstances if pre-warmed to 37oC and maintained for at least 30 minutes to release the autoabsorbed antibody back into the plasma prior to separation and testing. However, this is not always successful. Dispensing incorrect quantities will adversely affect the outcome of this test, resulting in a falsely increased or decreased titre. The technique for reading the test to detect agglutination is critical. Weak or fragile agglutinates may break apart, resulting in a false negative result and a false decrease in the reported titre. The reaction between a true cold agglutinin and the red blood cells is reversible. To prove the presence of a true cold agglutinin, all tests showing agglutination at 4oC must revert to negative after incubation at 37oC for 15 - 30 minutes. If agglutination remains, the antibody involved is not a true cold agglutinin.

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• Routine Contact Name:

  FH Section Leads
  RVI Section Leads

• Routine Telephone:

  Freeman: 0191 213 7849
  RVI: 0191 282 4335

  Freeman: 0191 213 7849
  RVI: 0191 282 4335

• Specialist Test:

  Yes

  Yes

• Specialist Contact Name:

  Transfusion manager

  Transfusion manager

• Specialist Telephone:

  0192 213 9169

  0192 213 9169