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Newborn Direct Antiglobulin Test (IgG-Gel)

Newborn Type/Gel DAT, Newborn Gel DAT

Test Codes

EPIC: LAB5280, Beaker: DATGL

Department

Blood Bank

Instructions

• This test is for neonatal patients (less than 4 months). For all other, please see Direct Antiglobulin Test.
• For a Newborn Type and DAT, please see Newborn Type with DAT.

Specimen Collection Criteria

Collect (preferred specimen): Infant Heel Stick - One Pink-top EDTA Microtainer®, properly labeled. (Minimum Volume: 0.5 mL)
Also acceptable: Cord Blood* - One Pink-top EDTA tube, properly labeled (single birth only). (Minimum Volume: 0.5 mL)

It is extremely important that blood samples are accurately labeled. Inpatient labels must include the following information:

*Note: Cord blood specimens cannot be used for transfusion purposes. Samples cannot be tested for a DAT more than 24 hours past the time of collection.

Heel Stick Labeling: 

1. Patient's Name: Complete name, last name first. If the patient uses a first initial followed by a middle name, both must appear in proper order on the label.
2. Wrist Band Number: Include the prefix letter, 5 numbers (example: N12345).
   NOTE: Newborns who have not yet been discharged will likely still be wearing the "N" wristband; so for example, the sample should be labeled in the format "N12345." Specimens lacking this complete information cannot be used for blood transfusion purposes and will be rejected.
3. Hospital Identification Number: The seven digit medical record number must be included on the label.
4. Date and Time Collected
5. Identification of Collector: Employee ID number must be on the sample tube or documented in the computer system.

Royal Oak and Troy 

Cord Blood Labeling: 

1. HIS Label with Mother’s Name: Complete name of mother (first and last) with the words "cord blood" written on the label at Royal Oak.  
2. LIS Label with Infant’s complete name (first and last) and hospital identification number.
3. Wrist Band Number of the Infant: Include the prefix letter, 5 numbers (example: N12345).  
4. Hospital Identification Number: Mother's hospital ID number must be on all cord blood specimens on HIS label. 
5. Date and Time Collected  
6. Identification of Collector: Employee ID number must be on the sample tube.

Farmington Hills and Trenton

Cord Blood Labeling: 

1. HIS label with Infant’s complete name (first and last) and hospital identification number.
2. Infant Wristband Number: Include the prefix letter, 5 numbers (example: N12345).
3. Date and Time Collected.  
4. Identification of Collector: Employee ID number must be on the sample tube.
5. HIS label must be labeled with Cord Blood either via sticker or hand written.
6. Farmington Hills Only: Sample must arrive in a specimen bag with mother’s identification information which includes name, MRN, B number, date/time and initials of collector.

Dearborn, Grosse Pointe, and Wayne

Cord Blood Labeling: 

1. LIS Label with Infant’s complete name (first and last) and hospital identification number.
2. Infant Wristband Number: Include the prefix letter, 5 numbers (example: N12345). Wrist band numbers are not required on cord blood samples, as they are not used for blood transfusion purposes.  
3. Date and Time Collected. 
4. Identification of Collector: Employee ID number must be on the sample tube.
5. Cord Blood identified on label by sticker, color, or hand written. 

For Beaumont Reference Laboratory (Outreach) patients, please refer to the Laboratory Bulletin on Laboratory Specimens: How to Label Correctly. 

Physician Office/Draw Specimen Preparation

Maintain specimen at room temperature (20-26°C or 68-78.8°F) or refrigerated (2-8°C or 36-46°F) prior to transport.

Preparation for Courier Transport

Transport: Whole blood at room temperature (20-26°C or 68-78.8°F) or refrigerated (2-8°C or 36-46°F). 

Rejection Criteria

• Cord blood samples from multiple births.
• Improperly labeled specimens.
• Specimens with inadequate volume.
• Specimens collected in SST tubes.
• Specimens contaminated with IV fluids.
• Specimens grossly contaminated with Wharton's Jelly.
• Hemolyzed samples will be tested only in emergency situations.

Storage

Specimen Stability for Testing:

Room Temperature (20-26°C or 68-78.8°F): 24 hours
Refrigerated (2-8°C or 36-46°F): 48 hours
Frozen (-20°C/-4°F or below): Unacceptable

Specimen Storage in Department Prior to Disposal:

Refrigerated (2-8°C or 36-46°F): Specimens are held for a minimum of 7 days.

*Once a sample arrives in Blood Bank, it cannot be shared with other laboratories.

Laboratory

Royal Oak Transfusion Medicine Laboratory (Blood Bank)
Dearborn Transfusion Medicine Laboratory (Blood Bank)

Performed

Sunday – Saturday, 24 hours a day.
Results available within 2 hours of receipt in the Blood Bank for routine inpatient requests and as close to 8 hours after receipt in the Blood Bank for outpatient specimens.

Reference Range

Negative.

Test Methodology

Hemagglutination.

Interpretation

• This test is for neonatal patients. For all others please see Direct Antiglobulin Test.
• The DAT detects the presence or absence of IgG on human red blood cells. It does not detect complement components bound to red blood cells.

Clinical Utility

The direct antiglobulin test detects in vivo sensitization of red cells. Direct antiglobulin testing is useful in the diagnosis of hemolytic disease of the newborn (HDN), auto immune hemolytic anemia, drug induced hemolytic anemia, and adverse reactions to transfusion due to RBC incompatibility.

CPT Codes

86880

Contacts

Last Updated

10/7/2023