Immunohematology Reference Laboratory

At our immunohematology reference laboratories (IRLs), we have the coveted combination of talent, expertise and rare reagents to deliver definitive results. Our services give you and your clinicians the confidence to move forward in providing transfusion therapy to your patients.

With our state-of-the-art equipment, experienced technical team and proximity to transportation hubs for ultra-reliable receiving, Blood Systems Laboratories is the provider of choice for hospital transfusion services from all over the U.S. for:

  • complex red cell serological testing
  • molecular genetic testing for erythrocytes and platelets
  • platelet antibody screening
  • platelet crossmatching

For clinical consultations, please see Contact Us for desired location.

Contact us to discuss any of our tests or services.

Indicate on the IRL order form if samples are for a patient who is receiving or who is scheduled to receive daratumumab (i.e. DARZALEX™ or DARA) anti-CD38 therapy for multiple myeloma.

Laboratory Category Test Name Description Turn Around Times Sample, Packaging & Shipping Requirements CPT Code Form
IRL Red Cell Serology 4C Antibody Identification

Test for identification of antibodies reactive best at 4C

Depends upon request; See TAT description 1 plain red top and 4 EDTA tubes (No gel separator tubes); Shipped in a container maintaining temperature between 1C - 10 C 86870 Form BS 313
IRL Red Cell Serology ABO Discrepancy (includes A2 cells & anti-A,B)

Resolution of ABO blood group typing discrepancies

Depends upon request; See TAT description 1 plain red top and 4 EDTA tubes (No gel separator tubes); Shipped in a container maintaining temperature between 1C - 10 C 86900 Form BS 313
IRL Red Cell Serology ABO Grouping

ABO blood group typing

Depends upon request; See TAT description 1 plain red top and/or EDTA tube; Shipped in a container maintaining temperature between 1C - 10 C 86900 Form BS 313
IRL Red Cell Serology Adsorption

Autoadsorption using patient’s own cells or allogeneic adsorption using reagent red cells of known phenotype

Depends upon request; See TAT description 1 plain red top and 4 EDTA tubes (No gel separator tubes); Shipped in a container maintaining temperature between 1C - 10 C 86978 Form BS 313
IRL, Transfusion Service Compatibility Testing & Product Services, Red Cell Serology Antibody Detection (screen)

Red cell antibody screen by multiple methodologies

Depends upon request; See TAT description 1 plain red top and/or EDTA tube; Shipped in a container maintaining temperature between 1C - 10 C 86850 Form BS 313, Transfusion Services Order Form TS 003
IRL, Transfusion Service Compatibility Testing & Product Services, Red Cell Serology Antibody Identification Panel

Red cell antibody identification by multiple methodologies

Depends upon request; See TAT description 1 plain red top and 4 EDTA tubes (No gel separator tubes); Shipped in a container maintaining temperature between 1C - 10 C 86870 Form BS 313, Transfusion Services Order Form TS 003
IRL Red Cell Serology Antibody Screen – Gel

Red cell antibody screen by gel technology

Depends upon request; See TAT description 1 plain red top and/or EDTA tube; Shipped in a container maintaining temperature between 1C - 10 C 86850 Form BS 313
IRL Red Cell Serology Antigen Typing, Donation (per antigen)

Donor blood typing for common antigens (serological)

Depends upon request; See TAT description 1 plain red top and/or EDTA tube; Shipped in a container maintaining temperature between 1C - 10 C 86902 Form BS 313
IRL Red Cell Serology Antigen Typing, Patient (per antigen)

Patient blood typing for common antigens (serological)

Depends upon request; See TAT description 1 plain red top and/or EDTA tube; Shipped in a container maintaining temperature between 1C - 10 C 86905 Form BS 313
IRL Red Cell Serology Antigen Typing, Rare-Donation (per antigen)

Donor blood typing for rare antigens (serological)

Depends upon request; See TAT description 1 plain red top and/or EDTA tube; Shipped in a container maintaining temperature between 1C - 10 C 86902 Form BS 313
IRL Red Cell Serology Antigen Typing, Rare-Patient (per antigen)

Patient blood typing for rare antigens (serological)

Depends upon request; See TAT description 1 plain red top and/or EDTA tube; Shipped in a container maintaining temperature between 1C - 10 C 86905 Form BS 313
IRL Red Cell Serology Cold Agglutinin Screen

Test for detection of antibodies reactive best at 4C

Depends upon request; See TAT description Serum/plasma collected and separated at 37 C and 1 EDTA. Please contact the IRL. 86156 Form BS 313
IRL Red Cell Serology Cold Agglutinin Titer

To provide instructions for determining the titer of cold reactive autoantibody for cases in which cold agglutinin disease is suspected.

Depends upon request; See TAT description Serum or plasma separated from freshly collected blood; sample maintained at 37C; minimum volume 2mL 86157 Form BS 313
IRL Red Cell Serology Computer Unit Search

Computer search of the Blood Systems inventory for specifically typed products

2 hours NA NA Contact IRL Laboratory
IRL Red Cell Serology Direct Antiglobulin Test (DAT) (per test)

The direct antiglobulin test is used to demonstrate antibodies and/or complement bound to the red cells “in-vivo”.

Depends upon request; See TAT description 1 EDTA tube; Shipped in a container maintaining temperature between 1C - 10 C 86880 Form BS 313
IRL Red Cell Serology Donath-Landsteiner Test

Diagnostic test for Paroxysmal Cold Hemoglobinuria (PCH)

Depends upon request; See TAT description Serum collected and separated at 37 C and 1 EDTA. Please contact the IRL. 86940, 86941 Form BS 313
IRL Red Cell Serology Drug Dependent Antibody Studies

Tests for identification of drug dependent antibodies

Depends upon request; See TAT description 2 large EDTA or red top tubes; sample of drug under investigation, in the same form (tablet, solution, capsules) that the patient is receiving 86850, 86970, 86975, 86976 Form BS 313
IRL Red Cell Serology Elution

Removal of antibody from red cells for further identification testing

Depends upon request; See TAT description 2 EDTA tubes; Shipped in a container maintaining temperature between 1C - 10 C 86860 Form BS 313
IRL Red Cell Serology Enzyme Treatment Panel

Premodification of red blood cells using proteolytic enzymes (i.e. Ficin, Papain, etc.)

Depends upon request; See TAT description NA 86870, 86971 Form BS 313
IRL Red Cell Serology Extended Phenotype

Patient typing for common blood group antigens, excluding Rh

Depends upon request; See TAT description 1 EDTA tube ; Shipped in a container maintaining temperature between 1C - 10 C 86905x9 Form BS 313
HLA, IRL Platelet Refractory Panel, Platelet Testing HLA (A,B) IR for Patient Platelet Transfusions

DNA based assay provides intermediate resolution (2 digits) typing of HLA-A,B alleles. Typing required for patient before search for HLA matched platelets.

48 hours Adults: 10-20 mL EDTA; Adults WBC <4x10^6/mL or 4000/µL: 20-40 mL EDTA; Pediatrics: Consult with laboratory 81373x2 Form BS 313, HLA Requisition Form BS 320H
HLA, IRL HLA Class I & II Antibody Screen and ID, Platelet Refractory Panel HLA Antibody ID Class I

Identification of antibody specificities to HLA Class I (A,B,C) antigens by Luminex microbead array methodology

3 business days 10 mL clotted whole blood in red top tube; blood specimens may be kept at room temperature and shipped at room temp or 24C up to 4 days after collection; OR separated serum from clot tube may be refrigerated at 4C and shipped up to 7 days from date of draw 86832 Form BS 313, HLA Requisition Form BS 320H
HLA, IRL HLA Class I & II Antibody Screen and ID, Platelet Refractory Panel HLA Antibody Screen

Screen for antibodies to HLA Class I (A,B,C) and Class II (DR,DQ,DP) and MIC antigens by Luminex microbead array methodology

3 business days 10 mL clotted whole blood in red top tube; blood specimens may be kept at room temperature and shipped at room temp or 24C up to 4 days after collection; OR separated serum from clot tube may be refrigerated at 4C and shipped up to 7 days from date of draw 86828 Form BS 313, HLA Requisition Form BS 320H
HLA, IRL Platelet Refractory Panel HLA Matched Platelet Pheresis Donor Search

Search of maintained registry of previously HLA typed donors to identify suitably HLA matched or compatible platelet pheresis donors for patients who are refractory to random donor platelets due to HLA antibodies. For patients that have previously completed HLA A,B typing or concurrent orders for HLA typing.

Same Day NA 99090 HLA Requisition Form BS 320H
IRL Red Cell Serology Lectin Study

Diagnostic test for polyagglutination

Depends upon request; See TAT description 1 EDTA tube; Shipped in a container maintaining temperature between 1C - 10 C 86999 Form BS 313
IRL Blood Donor Typing, Molecular Testing (DNA Genotyping) Molecular Platelet Genotyping (HPA) – Donor

Molecular determination of 11 allelic variants that determine common Human Platelet Antigens, using multiplex PCR and microarray analysis. Includes DNA extraction and purification.

5-7 Business Days 1 EDTA ( 7mL) tube NA Form BS 313
IRL Molecular Testing (DNA Genotyping), Platelet Testing Molecular Platelet Genotyping (HPA) – Patient

Molecular determination of 11 allelic variants that determine common Human Platelet Antigens, using multiplex PCR and microarray analysis. Includes DNA extraction and purification.

5-7 Business Days 2 EDTA (7 mL) tubes 81479 Form BS 313
IRL Blood Donor Typing, Molecular Testing (DNA Genotyping) Molecular Red Cell Genotyping (HEA) – Donor

Molecular determination of 38 allelic variants that determine common and rare red cell antigens plus hemoglobin S status, using multiplex PCR and microarray analysis. Includes DNA extraction and purification.

5-7 Business Days 1 EDTA ( 7mL) tube NA Form BS 313
IRL Molecular Testing (DNA Genotyping) Molecular Red Cell Genotyping (HEA) – Patient

Molecular determination of 38 allelic variants that determine common and rare red cell antigens plus hemoglobin S status, using multiplex PCR and microarray analysis. Includes DNA extraction and purification.

5-7 Business Days 2 EDTA (7 mL) tubes 81403 Form BS 313
HLA, IRL Platelet Refractory Panel, Platelet Testing Platelet Antibody Detection

The Capture-P Ready Screen Solid Phase System is designed to detect IgG- HPA and -HLA antibodies. The assay does NOT differentiate between HLA or HPA antibodies. The assay is not designed to detect complement components or antibodies of the IgM or IgA class.

Depends upon request; See TAT description 3-7 mL EDTA (plasma) or serum tube (no gel separators). Sample must be received in the IRL no later than 30 hrs after collection. Shipped in a container maintaining temperature between 1C - 10C 86022 Form BS 313
IRL Platelet Refractory Panel, Platelet Testing Platelet Crossmatch – SP

The Capture-P Solid Phase System is designed to detect IgG HPA and HLA antibodies.  The assay is not designed to detect complement components or antibodies of the IgM or IgA class.

Depends upon request; See TAT description 3-7 mL EDTA (plasma) or serum (not from gel separator tubes). ; Must be received within 30 hours of collection. ; Shipper to maintain temperature between 1C - 10C 86022 Form BS 313
HLA, IRL Platelet Refractory Panel Platelet Refractory Panel

Platelet antibody screen and crossmatch, HLA A,B typing, HLA matched platelet donor search, HLA antibody screen (if positive, HLA antibody identification Class I)

48 hours Three EDTA whole blood, and 5-7 mL clot (serum) tube (no gel separators). Sample must be received in the IRL no later than 30 hrs after collection. Icteric, hemolyzed and/or lipemic samples interfere with test and should not be tested as per package insert. Shipped in a container maintaining temperature between 1C - 10C 99090 Form BS 313, HLA Requisition Form BS 320H
IRL Red Cell Serology Red Cell Separation

Separation of patient red cells from transfused red cells

Depends upon request; See TAT description 2 EDTA tubes; Shipped in a container maintaining temperature between 1C - 10 C 86999 Form BS 313
IRL Red Cell Serology Red Cell Treatment – EGA/CHL/DTT

Chemical premodification of red cells for testing

Depends upon request; See TAT description 2 EDTA tubes; Shipped in a container maintaining temperature between 1C - 10 C 86970 Form BS 313
IRL Red Cell Serology Rh (D) Typing

Rh (D) typing of red cells

Depends upon request; See TAT description 1 EDTA tubes; Shipped in a container maintaining temperature between 1C - 10 C 86901 Form BS 313
IRL Red Cell Serology Rh Discrepancy

Resolution of typing discrepancy

Depends upon request; See TAT description 2 EDTA tubes; Shipped in a container maintaining temperature between 1C - 10 C 86901x3 Form BS 313
IRL Red Cell Serology Rh Phenotype

Common Rh antigen phenotyping, excluding Rh (D)

Depends upon request; See TAT description 1 EDTA tube; Shipped in a container maintaining temperature between 1C - 10 C 86906 Form BS 313
IRL Red Cell Serology Special Serum Studies (0.01 M DTT, others)

Selective inactivation of IgM class immunoglobulin

Depends upon request; See TAT description 1 plain red top and 4 EDTA tubes (No gel separator tubes); Shipped in a container maintaining temperature between 1C - 10 C 86975 Form BS 313
IRL Red Cell Serology Special Serum Studies (Neutralization/Inhibition, i.e. Le & P1 substance)

Antibody inhibition using blood group substances

Depends upon request; See TAT description 1 plain red top and 4 EDTA tubes (No gel separator tubes); Shipped in a container maintaining temperature between 1C - 10 C 86977 Form BS 313
IRL Red Cell Serology Thermal Amplitude

Determination of optimal temperature of reactivity of cold antibodies

24 hours Serum collected and separated at 37 C and 1 EDTA. Please contact the IRL. 86940, 86941 Form BS 313
IRL Red Cell Serology Titration Studies (per titration)

Serial dilution of the sample and testing

NA 1 plain red top and 1 EDTA tubes (No gel separator tubes); Shipped in a container maintaining temperature between 1C - 10 C 86886 Form BS 313
IRL Red Cell Serology Turn Around Times

STAT: 8 hours;  ASAP: 24 hours;  Routine: 1-2 days

Depends upon request; See TAT description Insufficient sample or incomplete patient information may result in delays NA NA

Blood Systems and its divisions and affiliates provide comprehensive transfusion medicine services. These include: BioCARE • Blood Services (Blood Centers of the Pacific, BloodSource, Bonfils Blood Center, Community Blood Services, Inland Northwest Blood Center, Lifeblood, LifeShare, LifeStream, United Blood Services) • Blood Systems Laboratories • Blood Systems Research Institute • Creative Testing Solutions

BSI-K-L1

Blood Systems
National Office
6210 E. Oak Street
Scottsdale, AZ 85257
(800) 288-2199