Laboratory Testing Service

Blood Centers of the Pacific Reference Lab
270 Masonic Avenue, San Francisco, CA 94118
Phone: 415-749-6681 or 888-673-3522
FAX: 415-749-6688

Medical Director: Salima Shaikh, M.D.

The Immunohematology Reference Laboratory (IRL) at Blood Centers of the Pacific provides specialized serological testing and consultation services to aid hospitals in the resolution of red blood cell (RBC) serological problems. We offer technical expertise in the areas of red cell serology testing as well as platelet compatibility testing to ensure the safety and well-being of patients and their transfusion needs. The Blood Centers of the Pacific IRL is accredited by the American Association of Blood Banks (AABB) and CLIA, is FDA-certified, and licensed by the State of California for high-complexity testing. This laboratory is also an active member of the American Rare Donor Program (ARDP), which provides a nation-wide search service for rare blood that is difficult to procure and not readily available at a local level.

The IRL is staffed 24 hours a day/7 days a week. On-site staffing is available from 8:00 AM until 9:00 PM on weekdays Monday through Friday. On-call staffing is made available for emergency (STAT) testing after regular business hours, on weekends and on holidays.

Guidelines for Referral Status & TAT’s

The turn-around-times (TAT’s) for referred samples can vary depending on the complexity of the request. See below for general TAT descriptions:

STAT** (Life-threatening emergency) 8 hours (fees may apply**)
ASAP (Transfusion needed NOT life-threatening) 24 hours
Routine (not urgent) 1-4 days

All TAT’s are measured from the time the sample is received by the testing laboratory.

The following questions are designed to help identify and differentiate which referrals should be elevated to an emergency (STAT **) status:

  1. Does the patient have any of the following clinical symptoms?
    • High output failure: heart failure-rapid beating with insufficient O2 delivery.
    • Angina: coronary artery disease with persistent decrease in O2 delivery to the myocardial muscle.
    • Impending stroke: cerebral vascular disease with persistent decrease in O2 delivery to the cerebrum.
  2. Is the patient actively bleeding? Note: a rapid drop in hemoglobin (>1 gm/dL / 24 hours) places the patient at risk.
  3. Does the patient require surgery during the next 24 hours?
  4. Are all units incompatible?

Emergency (STAT**) status should be considered for patients who:

  • Demonstrate any of the symptoms listed in #1
  • Answer “yes” to questions #2 and #4
  • Answer “yes” to questions #3 and #4

Platelet Crossmatching samples must be received no later than 12:00pm on the day of testing if units are required for transfusion that same day. All samples for platelet testing received after 12:00pm may be subject to delayed testing and cannot be guaranteed to receive units that same day.
Molecular Genotyping (red cell or platelets): Routine (7-10 days)
HLA Testing (HLA A, B (IR) typing, HLA antibody): Routine (48-72 hours)

IRL Test Menu

Blood Centers of the Pacific Immunohematology Reference Laboratory offers the following list of testing services:

Tests Performed: Red Cell Serology

  • ABO/Rh Grouping
  • ABO/Rh Discrepancy Resolution
  • Antibody Screen
  • Antibody Identification
  • Adsorption Studies– Autologous or Allogeneic
  • Direct Antiglobulin Test (DAT)
  • Elution
  • Antigen Typing
  • HDFN Evaluation
  • Red Cell Extended Phenotype (Serological)
  • Red Cell Separation
  • Red Cell Molecular Genotype (complete/RHCE/RHD)
  • Red Cell Chemical Treatment (EGA, DTT, CQT)
  • Titration Studies
  • Adsorption/Elution Studies
  • Transfusion Reaction Investigation
  • Special Serum Studies (0.01M DTT, Neutralization, Inhibition)

Tests Performed: Platelets

  • Platelet Antibody Screen
  • Platelet Crossmatch/Compatibility

IRL Sample Requirements

(No gel-separator tubes)

Test Request Sample Requirements
Red Cell Serological Testing 1 clot tube
2-4 EDTA tubes
Platelet Testing 2-4 EDTA tubes
HDFN Evaluation Mom: 1 clot tube, 2-3 EDTA tubes
Baby: 2-10 mL cord blood
HLA A,B (IR) typing HLA A,B (IR) typing 3 ACD-A tubes or 1-3 EDTA tubes (please inquire with IRL lab which to send)
HLA Class I antibody screen/ID 1-2 clot tubes
Molecular testing (genotyping) 1-2 EDTA tubes

For recently transfused patients, include a pre-transfusion specimen if available. Patient samples must be labeled with all of the following: (Improperly labeled samples will be rejected)

  • Patient’s first and last name
  • Medical record identification number
  • The date and time the samples were drawn
  • Initials/name of the phlebotomist.

Include a list of the patient’s medications whenever possible. Attach copies of the work performed at your facility. Samples for RBC serological testing should be shipped in a container that maintains a temperature between 1oC – 25oC, and should arrive in the IRL within 24 hours after they are collected. Please thoroughly complete the Reference Laboratory Request Form (BS 313) and contact the Blood Centers of the Pacific IRL personnel before sending samples and to arrange sample pick-up and/or shipping.

Reporting and Billing

Preliminary reports (prior to final review) and billing information will be faxed when testing is completed. Final reports are faxed and mailed to the hospital after the final review has been completed. Billing for testing services is handled through the normal billing process at BCP.