FAQs


Frequently Asked Questions


Neutrophil Laboratory Hours

The Neutrophil Immunology Laboratory is open Monday through Friday between the hours of 8 a.m. and 4:30 p.m. Central Time.

If you have a question outside of regular hours you may e-mail the laboratory at BRSTPaulMNNeutrophil@redcross.org, supervisor Randy.Schuller@redcross.org or leave a message by phone 855-216-9202.


Neutrophil Laboratory Testing FAQs


 

Q: When do you perform neutrophil antibody testing?

A: Testing for neutrophil antibody is performed weekly. We typically schedule testing every Wednesday; however, due to holidays or unanticipated events this can change.

Q: What lab methods do you use to detect neutrophil antibodies?

A: We routinely use a combination of the granulocyte immunofluorescence test (GIFT) and the granulocyte agglutination test (GAT) to detect and identify antibodies to human neutrophil alloantigens (HNA). This testing scenario is based on the recommendation of the International Society of Blood Transfusion (ISBT) Granulocyte Immunobiology Working Party (GIWP).

Q: Why are 2 tests critical for HNA antibody detection?

A: Most laboratories only utilize GIFT when testing for neutrophil antibodies. The International Granulocyte Immunology Workshops (IGIW) are quality assessment exercises that are distributed annually to laboratories which are members of the GIWP. Results from previously analyzed samples have confirmed that GAT is an essential technique when detecting agglutinating HNA antibodies. In fact, two IGIW assessments have included HNA-3a antibodies which could only be detected using the GAT method. This is critical as the HNA-3a antibody has been consistently associated with severe and multiple fatal cases of transfusion-related acute lung injury (TRALI).

Q: What other tests do you use?

A: HLA Class I antibodies are also detected in GAT and GIFT so the monoclonal antibody immobilization of neutrophil antigens (MAINA) test is used to differentiate HNA antibodies from HLA antibodies. In the MAINA test, HLA Class I antibodies are removed, leaving only the HNA antibodies available for detection.

We can utilize the neutrophil crossmatch to aid in the diagnosis of alloimmune neonatal neutropenia and TRALI. We also test for drug dependent neutrophil antibodies. Both of these tests are available upon request.

When HNA antibody has been identified it is important to confirm the HNA antibody specificity by determining the patient's or donor's neutrophil antigen type. Both serological (phenotype) and molecular (genotype) methods are used to determine the neutrophil antigen type. The following neutrophil associated antigens are detected by each method.

Genotyping Phenotyping
HNA-1a/1b/1c HNA-1a/1b/1c
HNA-3a/3b HNA-2
HNA-4a/4b HNA-3a
HNA-5a/5bw HNA-4a

 


Specimen Requirements FAQs


 

Q: Where can I find sample requirements for your tests?

A: Specimen requirements for all our tests are available on our Request for Neutrophil Services form . You can also find specimen requirements for each neutrophil clinical condition in our Indications section.

Q: Why would you reject a specimen?

A: The most common reason we reject a specimen is when its identification is compromised. A simple rule of thumb is if the information on the sample vial is inaccurate, incomplete or missing we cannot accept it for testing. We will investigate every situation a labeling issue occurs and contact you via phone or email to determine if the specimen is acceptable for testing.

Q: Will you provide us a test report if a specimen is rejected?

A: Yes, we will send a report for every specimen that we receive in our laboratory. If the specimen was rejected we will provide detailed information why we could not test it.

Q: What are some other reasons you would reject a sample from being tested?

A: The integrity of the specimen is essential for accurate results. Integrity of the specimen can be compromised for multiple reasons during its collection, storage, or transportation. A common circumstance is when a sample has been contaminated before or during shipment or it leaked during transit. Another reason to reject a specimen would be incorrect sample type, such as a segment from a donor component or if the specimen was collected in a gel separator tube. In some cases we can perform testing on suboptimal specimens, such as when a specimen exhibits hemolysis or if lipemia is present. In every case we will contact you via phone or email to let you  know when your specimen has been rejected.

 


Requisition Form FAQs


 

Q: Do I need to complete a requisition form for each patient specimen?

A: Yes, a completed Request for Neutrophil Laboratory Services form must accompany each specimen referred to the Neutrophil Immunology Laboratory.

Q: Why do I need to complete a requisition form?

A: The simple answer to your question is that it is a requirement of the Clinical Laboratory Information Act (CLIA). 42 CFR 493.1241 states that each laboratory that performs non-waived testing must provide a request from an authorized person. Another important reason is that it aids in the proper identification of specimens which is crucial when providing accurate laboratory results.

Q: What is the minimum information that CLIA requires?

A: (1) The name and address of the authorized person requesting the test or the name and address of the laboratory submitting the specimen, including, a contact person to enable us to report lab results in a timely manner.

(2) The patient’s name or unique patient identifier.

(3) The sex and age or date of birth of the patient.

(4) The test(s) to be performed.

(5) The source of the specimen, when appropriate.

(6) The date and, if appropriate, time of specimen collection.

(7) Any additional information relevant and necessary for a specific test to ensure accurate and timely testing and reporting of results, including interpretation, if applicable.

Q: How do I complete your requisition form?

A: Complete the Patient/Donor Information and Specimen Information sections located at the top of the form. You can enter this information directly onto the form from your computer. Many clients attach the patient’s medical record label which can also be attached to the specimen vial. The bottom left side of the form is used for clinical specimens to diagnosis the patient’s clinical conditions. The right side of the form is used specifically for transfusion-related acute lung injury (TRALI) investigations associated with adverse reactions observed with blood transfusions.

Q: Where can I access a requisition form?

A. Just click this link to the Request for Neutrophil Services form. As stated earlier you can enter the required information directly onto the form from your computer and print it out.

 


Shipping FAQs


 

Q: What are the requirements for sending specimens to your lab?

A: Diagnostic specimens must be shipped according to federal and local requirements for Shipping Biological Substances Category B. Contact your overnight carrier for specific requirements.

Q: What are the requirements for shipping frozen specimens?

A: Serum and plasma specimens should be separated from the red cells and frozen immediately. Frozen specimens should be insulated and packed with dry ice. Dry ice is considered a hazardous material and must be packaged following Department of Transportation (DOT), International Air Transport Association (IATA) and your carrier requirements.

Q: What are the requirements for shipping specimens at refrigerated or at ambient temperatures?

A: Refrigerated specimens should be packed with frozen or cold gel (ice) packs. Insulate the specimen tubes to prevent freezing.

A: Specimens shipped at ambient temperature should be insulated to prevent damage from extreme shipping temperatures.

Q: When should I send samples to your laboratory?

A: Specimens should be sent by overnight carrier Monday through Thursday to ensure weekday delivery. The Neutrophil Immunology Laboratory is not staffed on weekends or holidays. We observe the following holidays: New Years Day, Memorial Day, the Fourth of July, Labor Day, Thanksgiving and Christmas Day.

Q: Where should I send specimens?

A: Neutrophil Immunology Laboratory

American Red Cross

North Central Blood Services Region

100 South Robert Street

St. Paul, MN

55107-1489

Q: If I have any further question, can I call you?

A: Yes, you can call us at 855-216-9202 Monday through Friday between 8 a.m. and 4:30 p.m.

 


Results and Reports FAQs


 

Q: How are final test results delivered to us?

A: Final results are reported to the referring institution after all testing has been completed and reviewed. An interpretation of your test results is included with each report and may also include recommendations and references. You can select your preferred method to receive results by selecting the options on the corresponding Request for Neutrophil Services form you submitted with each specimen. Routine delivery options are via mail or fax. We can also provide a scanned report in pdf format by e-mail upon request.

Q: Do you provide preliminary test results?

A: Yes, preliminary test results are routinely reported. Typically, specimens that exhibit reactivity to neutrophil antibodies are retested on the next scheduled test run to determine if HNA antibody specificity can be determined.

Q: Can we order a STAT test?

A: Since we only schedule neutrophil antibody testing once per week, STAT testing is not available.

Q: Can we cancel a test?

A: Tests can be canceled without charge if we receive notification prior to processing the specimen. Processing occurs the day prior to our scheduled testing date. A final report will be issued with the cancellation information included.

Q: What is a CPT code?

A: CPT is an abbreviation for Current Procedural Terminology and is used to describe the testing we have performed on the samples you have submitted. The CPT code can be used as a guide to assist you in your internal billing process. CPT codes are available on our web-site or available upon request.

Q: What are LOINC codes?

A: LOINC or Logical Observation Identifiers Names and Codes is a database for identifying medical laboratory observations in an electronic format. Additional information regarding LOINC is available at this link.

 


Contact FAQs


 

Q: What if I have further questions?

A: E-mail the supervisor Randy.Schuller@redcross.org, the laboratory at BRSTPaulMNNeutrophil@redcross.org, or leave a message by phone 855-216-9202.

 

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