Tx Reaction Investigation (Sendout) [FHCC Community Sites Only]

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General Information

Lab Name
Tx Reaction Investigation (Sendout)
Lab Code
RTXINV
Epic Name
Tx Reaction Investigation (Sendout) (FHCC Community Sites Only)
External Test Id
3148-00
Description

Indications: If a patient experiences unexplained fever or change in vital signs or symptoms such as chest pain, shortness of breath, back pain, diaphoresis, red urine, or unexplained bleeding, the transfusion should be discontinued immediately, and a hemolytic transfusion reaction evaluation should be initiated. Acute hemolytic transfusion reactions, although rare (frequency ~1 in 20,000 transfusions) can be associated with life-threatening complications (intravascular hemolysis, renal failure, disseminated intravascular coagulation (DIC)).

    Delayed hemolytic transfusion reaction should be suspected if a patient develops fever, falling hematocrit, and/or hyperbilirubinemia approximately 3 to 7 days following a blood transfusion. These reactions are generally caused by IgG non-complement fixing red blood cell alloantibodies (e.g., anti-D, -c, -E, -K, -Fya, or -Jka).

      Test Information: The initial hemolytic transfusion reaction evaluation consists of a clerical check to verify proper patient and unit identification, a visual check of patient plasma for hemolysis, and a direct antiglobulin test. If the direct antiglobulin test is positive and/or the patient’s plasma is hemolyzed, an extended serologic evaluation will be performed.

        Ordering Note: This test code is for use by Fred Hutchinson Cancer Center (FHCC) community sites only. For transfusion reactions at UW-MT, UW-NW, HMC, or FHCC (main hospital), refer to separate test Transfusion Reaction Workup Transfusion Reaction Workup [TRRX].

        Forms & Requisitions
        Synonyms
        Transfusion reaction
        Components
        Code Name
        RTXRX Tx Reaction Investigation (Sendout)
        S2TXRX Tx Reaction Testing Lab

        Interpretation

        Method

        Visual hemolysis check
        DAT: Standard test tube methodology, Hemagglutination
        An extended serologic evaluation will be performed as needed.

        Reference Range
        See individual components
        Ref. Range Notes

        Reference Range: Negative

        Ordering & Collection

        Specimen Type
        Blood
        Collection

        7 mL blood in PINK (EDTA) tube

        • Also Accepted: LAVENDER TOP (EDTA) tube

        Pediatric Volumes:

        • 1-5 years old: 3 mL EDTA blood
        • < 1 year old: 2 full 0.5 mL EDTA microtainers

        Note: All blood bank samples require two signatures or initials (person drawing the sample and person verifying the patient ID) and handwritten date and time on the CID label. Patient name must exactly match the name on the sample label.

        Forms & Requisitions
        Quantity
        Requested: 7 mL EDTA whole blood
        Minimum: 6 mL EDTA whole blood (refer to Collection section for pediatric minimums)

        Processing

        Receiving Instructions

        Store and transport whole blood at ambient temperature. Promptly forward sample(s) to Bloodworks Northwest Compatibility Testing Laboratory along with a completed "Report of Suspected Hemloytic Transfusion Reaction" Form, the blood bag, and infusion set with attached IV fluids.

        Misc Sendout

        Performance

        Lab Department
        Transfusion Support(TS)
        Frequency
        Performed: Daily. Initial evaluation – 10 minutes. Extended evaluation – may require up to several hours.
        Available STAT?
        Yes
        Performing Location(s)
        Sendout Bloodworks Northwest
        206-292-6500

        921 Terry Ave
        Seattle, WA 98104

        Billing & Coding

        LOINC
        14924-5