Transfusion Reaction Workup

Transfusion Evaluation, Transfusion Reaction, Transfusion Reaction Evaluation

Test Codes

EPIC: LAB647

Department

Blood Bank

Specimen Collection Criteria

Collect: 6.0 mL Pink-top EDTA tube, properly labeled, collected POST REACTION.

• Draw specimen immediately POST REACTION and collect sample carefully to avoid hemolysis.
• Gently invert EDTA tubes 8-10 times after collection.

Preferred Volume: 6.0 mL
Minimum Volume: 3.0 mL

Specimen Labeling Requirement

Labels must include the following information:

1. Patient's Name: Complete name. 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 letters, 4 numbers, and a suffix letter (example: BR1234T). Specimens lacking this complete information cannot be used for blood transfusion purposes and will be rejected.
3. Hospital Identification Number: The medical record number must be included on the label.
4. Date and Time Collected
5. Identification of Collector: Employee ID number or first initial and complete last name must be on the sample tube or documented in the computer system.

Rejection Criteria

• Improperly labeled specimens.
• Specimens with inadequate volume.
• Specimens collected in inappropriate collection tubes.
• Specimens contaminated with IV fluids.
• Grossly hemolyzed samples must be redrawn and retested to confirm clinical hemolysis.

Inpatient Specimen Preparation

Transport the specimen STAT to the Blood Bank after collection.

In-Lab Processing

Centrifuge the specimen upon receipt in the laboratory.

Storage

Specimen Stability for Testing:

Room Temperature (20-26°C or 68-78.8°F): Specimens are tested immediately upon receipt in the Blood Bank.
Refrigerated (2-8°C or 36-46°F): Unacceptable
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 11 days.

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

Laboratory

Dearborn Transfusion Medicine Laboratory (Blood Bank)
Farmington Hills Transfusion Medicine Laboratory (Blood Bank)
Grosse Pointe Transfusion Medicine Laboratory (Blood Bank)
Royal Oak Transfusion Medicine Laboratory (Blood Bank)
Taylor Transfusion Medicine Laboratory (Blood Bank)
Trenton Transfusion Medicine Laboratory (Blood Bank)
Troy Transfusion Medicine Laboratory (Blood Bank)
Wayne Transfusion Medicine Laboratory (Blood Bank)

Performed

Sunday – Saturday, 24 hours a day.
Preliminary results available within 2 hours of receipt in the Blood Bank. A final pathologist's report will follow.

Results will be telephoned to the appropriate nursing personnel/physician if suspected acute hemolytic transfusion reaction or bacterial contamination.

Test Methodology

Hemagglutination.

Interpretation

• The Transfusion Reaction Evaluation work-up will always include a poly-specific direct antiglobulin test (DAT) and a clerical check. If indicated, this evaluation may include: differential DAT, repeat ABO/Rh typing, antibody screen, re-crossmatch of the transfused RBC unit, urinalysis, bilirubin, culture of the blood product, and re-crossmatch of additional units to be transfused (as applicable).
• The Transfusion Reaction Evaluation work-up will detect those reactions caused by red cell incompatibility.

Clinical Utility

Approximately 1-2% of all blood transfusions result in some type of reaction in the recipient. The most common symptoms are febrile non-hemolytic and allergic reactions. This test is used to determine the causes of the transfusion reaction. The Blood Bank is responsible for investigating all transfusion reactions. Future treatment of the patient may depend on the results of the investigation.

CPT Codes

86880 (DAT), 86078 (Physician Charge).

Contacts

Last Updated

9/10/2025