Immunohematology Reference Laboratory (IRL)

One of only four AABB IRL accredited labs in Texas, Carter BloodCare offers simple to complex antibody identification, compatibility testing, antigen negative units, red blood cell genotyping, centralized transfusion services, flow cytometry services and specialized platelet matching services. 

• Multiple serologic testing platforms and resources 

• Red cell genotyping for patient and donor phenotype determination 

• Collection of frozen rare reagent cells for complex antibody identification studies

• Extensive antigen negative unit inventory, including rare antigen types 

• Provision of samples to clients for use with validation, correlation and competency evaluations 

• 24/7 consults with physicians and technologists

• Assistance with clinical trial studies

The IRL is managed and staffed with certified medical laboratory scientists (MLS), multiple experienced specialists in blood banking (SBB) and Medical Directors (MD) that provide services 24 hours a day, 7 days a week. Additionally, other specialty trained staff in molecular, flow cytometry, and platelet services are available to support client needs.

Reference Laboratory Services

• Compatibility testing of confirmed antigen negative units

• Provision of historically antigen negative units (C,c,E,K) for cooperative management of the chronically transfused patient (i.e. hemoglobinopathies and thalessemia)

• Detection of unexpected antibodies and compatibility testing

• Modified workup for eligible chronically transfused patients

• Investigation and management of transfusion complications (transfusion reaction workups)

• Simple to highly complex antibody identifications using various techniques (including, but not limited to):

  • Techniques: Tube (LISS, PeG, Saline, Albumin), Gel, and Solid Phase (ECHO)

  • Enzymes (Ficin, Bromelin, Chloroquine, EGA, DTT, ZZAP, Trypsin)

  • Elutions (Lui Freeze Thaw, Landsteiner-Miller Heat or Low pH)

  • Adsorptions (REST, Autologous, Allogeneic, and Differential)

  • Titration studies (Routine, High Frequency Antibodies, Cold Agglutinin & Isohemaglutinins, ABO Incompatible Kidney Transplant)

  • Cold Agglutinins and Warm Auto Antibodies Studies

  • Special Techniques:

    • Red blood cell genotyping

    • Saline replacement

    • Acidification of serum

    • Neutralizations

    • Harvesting autologous RBCs

    • Donath-Landsteiner

    • Drug studies

    • Polyagglutination recognition

    • Thermal amplitude testing

  • Participation in the national SCARF program

• Provision of specialty products

Referral Testing

• Mononuclear Monocyte Assay (MMA) Testing & IgG Classification

• TRALI Investigations (Neutrophil Serology)

• Gram Stain & Culture (transfusion reaction investigation)

• Molecular RBC Sequencing

• Molecular Class I HLA Antigens Testing

• Molecular HPA 1a Confirmation Testing

Donor Testing

• Positive for unexpected antibody resolutions (IAT)

• Discrepancies results (DAT & ABO/Rh)

• Sickle cell testing

• Walk-in Donor ABO/Rh

• Antigen phenotyping (Molecular & Serology) to expand donor antigen database and identify rare blood group phenotypes

• HPA-1a and HLA testing to expand donor database

• ABO titers for Low Titer O Whole Blood

American Rare Donor Program (ARDP)

As a proud participant in America’s Rare Donor Program (ARDP), we provide and procure rare blood through nationwide searches to ensure all patients receive the blood they need throughout the nation. The ARDP was established in 1998 and assists in providing rare units throughout the US and the international community.

Molecular testing enables our team to increase its active rare donor contributions to the registry and help fulfill the requests, made on behalf of patients.

When the need for a rare unit(s) cannot be met locally or regionally, the ARDP is notified and sends out a national search notice. A blood center that can meet the request notifies ARDP or the designated facility to arrange shipment. If a Carter BloodCare donor meets the established qualifications of a “rare” donor, they are notified by the ARDP via Carter BloodCare and can choose to accept or decline participation in the ARDP program.

Centralized Transfusion Services

• On-site or remote transfusion services

• Centralized transfusion services designed for surgery centers

• Blood center physician participation on medical staff and relevant committees

• See available tests with sample requirements, test methods and turn-around times by clicking the button below

The IRL offers several options for transfusion services. These options include full service on-site, limited service on-site, and remote services.

Our experienced staff performs remote transfusion services. These services include determining patient blood group, detection and identification of unexpected antibodies, and provision of compatible plasma products (platelets, fresh frozen plasma, and cryoprecipitate) and crossmatch compatible red blood cells for transfusion. Emergency red cell units, massive transfusion protocol, on-site emergency red cell stock and rotation are available based upon need.

Full service on-site services includes experienced staff and equipment within the facility fulfilling all transfusion needs. These services include determining patient blood group, detection of unexpected antibodies, simple antibody identification, and provision of compatible products. Products such as platelets, thawed plasma, cryoprecipitate, red blood cells (antigen negative) would be provided and special manipulations such as aliquots, irradiation, thawing, and pooling could be included if appropriate. All policies, procedures, accreditation and regulatory requirements are provided by the IRL.

Limited on-site transfusion services are also available as an additional model based on facility need. The patient sample would be collected at the facility and shipped to Carter BloodCare. The laboratory performs transfusion services testing & provision of blood (as addressed above). A staff member and limited equipment would be on-site in the facility and when possible, the lab will electronically crossmatch unit(s) available on-site in the facility for the patient. The on-site staff member will be responsible for identifying and labeling these units, making them available for transfusion, rotating the inventory to prevent out dates, providing emergency release blood and issuing the compatible blood products.

Platelet Crossmatch Testing Services

Platelet matching services are available to help ensure optimal response to platelet transfusions in sensitized patients. These services are offered nationwide and include:

• Human leukocyte antigen (HLA) matching of donors and recipients

• Extensive HLA typed and HPA-1a antigen negative donor databases

• Platelet crossmatching (Capture – P solid phase technology)

• Platelet Antibody screens (PakPlus ELISA technology)

• Neonatal autoimmune thrombocytopenia (NAIT) studies 

• Consultation services with an experienced platelet HLA specialist

• Research project assistance

Flow Cytometry Services

• Residual white blood cell (WBC) determination for leukocyte-reduced component quality control for red cell and platelet components

• Cell surface marker (CD34, CD3, TCR alpha/beta+, CD19+) enumeration for patient monitoring and cellular therapy product analysis

• Fetal hemoglobin (Hgb F) quantification in maternal antepartum and postpartum specimens

• Consultation services with an experienced flow cytometry specialist

• Assistance in clinical trials and research projects

• Customized assays

Watch a video about our Flow Cytometry Laboratory to learn more.

Blood Product Quality Control

Our experts consult and perform product qualification for red blood cells, platelets and granulocytes.

• Hematocrit and hemoglobin concentration

• Platelet count

• Granulocyte white blood cell count and differential

• Bacterial detection for apheresis platelets

Molecular Testing Laboratory Services

The AABB accredited Molecular Testing Laboratory performs molecular testing to help doctors treat patients with weakened immune systems, and others who must receive ongoing blood transfusions. 

Patients who are chronically transfused, such as sickle cell patients, avoid repeat testing, and receive more precisely matched blood that is based on their molecular profile.

Donor and Patient Red Cell Genotyping

Molecular testing provides an accurate genotype and predicted phenotype for patients when serology is limited due to recent transfusion, multiple transfusions or patient red cells coated with immunoglobulins. Other services include sending out samples for RHD variant testing, RHCE variant testing, allele sequencing testing, and discrepancy workups, as appropriate.

Screening selected donor samples for rare genotypes since 2008 has resulted in a database over 7,500.