Donath-Landsteiner (Sendout)

General Information

Lab Name

Lab Code

RDLS

Epic Name

Donath-Landsteiner (Sendout)

External Test Id

3139-00

Description

Indications: This test may be ordered in a patient suspected of having paroxysmal cold hemoglobinuria (PCH). This entity is more common in children, and may be characterized by episodes of hemolysis upon exposure to cold temperatures.

Test Information: As PCH is classically due to an IgG antibody, preliminary tests such as a direct antiglobulin test using polyspecific Coombs reagent may be performed prior to proceeding with the Donath-Landsteiner test; this is to help differentiate PCH from cold agglutinin syndrome (CAS), when an IgM antibody is causing hemolysis.

Note: Special collection procedures are required. To arrange for testing, contact the Laboratory Medicine Resident on-call via the paging operator. The Bloodworks NW Immunohematology Reference Laboratory (206-689-6534) should be notified prior to sample collection.

Forms & Requisitions

Bloodworks Northwest Immunohematology Reference Laboratory Requisition

Synonyms

3139-00, Donath-Landsteiner Test for PCH, paroxysmal cold hemoglobinuria

Components

Code	Name
RDLSR	Donath-Landsteiner Result (Sendout)
S2DLS	Donath Landsteiner Testing Lab

Interpretation

Method: Standard test tube methodology, Hemagglutination
Reference Range: See individual components
Interferences and Limitations: Failure to maintain samples at 37°C prior to separation of serum from cells may cause a false negative result.

Ordering & Collection

Specimen Type

Blood

Collection

15 mL blood in a RED TOP tube kept warm after collection.

Maintain sample temperature at 37°C with heel warmer pad and walk sample to the lab immediately (NW220 at UW-MT or GWH-47 at HMC).
Upon arrival, notify the lab that the sample must be kept warm.

Unacceptable: Serum separator gel tube.

Forms & Requisitions

Bloodworks Northwest Immunohematology Reference Laboratory Requisition

Approval Required

Laboratory Medicine Resident approval required.

Quantity

Requested: 5 mL serum
Minimum: 5 mL serum

Processing

Receiving Instructions: If unable to centrifuge immediately, specimen can be held in a 37°C water bath for up to 15 minutes. Once sample is clotted, centrifuge and transfer serum to a separate, plastic aliquot.

Send serum sample at ambient temperature with a completed Bloodworks Northwest requisition or Epic requisition.

Note: A fresh source of complement is needed for the test. The LMR should call Platelet Immunology Lab at 206-689-6534 if a quick turnaround is desired.

Misc Sendout

Performance

Lab Department

Transfusion Support(TS)

Frequency

Performed: Daily. TAT: 24 hours on weekdays; 72 hours on weekends.

Available STAT?

Performing Location(s)

Sendout	Bloodworks Northwest 206-292-6500 921 Terry Ave Seattle, WA 98104

Billing & Coding

CPT Codes: 86940, 86941
LOINC: 18286-5